J Hypertens. 2021 Jun 1;39(6):1143-1154. doi: 10.1097/HJH.0000000000002793.
To assess the association between blood pressure (BP) with age and its heterogeneity across various sociodemographic subgroups in China.
In this cross-sectional study, we analysed the data from nearly 3.3 million individuals aged 35-75 years from all 31 provinces in mainland China collected from September 2014 through August 2019. On the basis of possible combinations of eight characteristics and antihypertensive status, subgroups of at least 10 000 individuals were created and the age--blood pressure relationship was determined for each group.
The study included 3 291 058 participants (59.6% women), with a mean age of 55.8 ± 9.8 years. The prevalence of hypertension was 47.6%, of which 30.0% were taking antihypertensive medications. The mean SBP was 135.9 ± 20.2 mmHg. SBP increased at a mean unadjusted rate of 0.639 ± 0.001 mmHg/year. For 95% of the 25 145 subgroups, the SBP increased by 0.28--0.85 mmHg/year. The most common characteristics in the subgroups with the steepest association were female sex, rural area, low education, low-income family, Tibet region, and farmer occupation. The increase in SBP ranged from 0.13 to 0.41 mmHg/year for 95% of the treated subgroups and from 0.33 to 0.82 mmHg/year for 95% of the untreated subgroups.
Blood pressure is positively associated with age in this study, with almost three-fold variation across subgroups, indicating subgroup differences in biology, behaviour, or exposures. Antihypertension strongly blunts the association of age and blood pressure and diminishes the variation.
评估中国不同社会人口亚组中血压（BP）随年龄变化的关系及其异质性。
在这项横断面研究中，我们分析了 2014 年 9 月至 2019 年 8 月期间来自中国内地 31 个省份的近 330 万 35-75 岁个体的数据。根据 8 种特征的可能组合和降压状态，创建了至少有 10000 名个体的亚组，并确定了每个组的年龄与血压关系。
研究包括 3291058 名参与者（59.6%为女性），平均年龄为 55.8±9.8 岁。高血压患病率为 47.6%，其中 30.0%正在服用降压药物。平均收缩压为 135.9±20.2mmHg。未经调整的平均收缩压每年升高 0.639±0.001mmHg。在 25145 个 95%置信区间亚组中，收缩压平均每年升高 0.28-0.85mmHg。在收缩压关联最陡峭的亚组中最常见的特征是女性、农村地区、低教育程度、低收入家庭、西藏地区和农民职业。在 95%的治疗亚组中，收缩压升高幅度为 0.13-0.41mmHg/年，在 95%的未治疗亚组中，收缩压升高幅度为 0.33-0.82mmHg/年。
本研究中血压与年龄呈正相关，亚组间差异变化近三倍，表明生物学、行为或暴露因素存在亚组差异。降压治疗强烈减弱了年龄与血压的关联，并降低了这种差异。
