Department of Epidemiology & Biostatistics, School of Public Health, Peking University.
Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China.
J Hypertens. 2024 Aug 1;42(8):1340-1349. doi: 10.1097/HJH.0000000000003717. Epub 2024 Mar 22.
How traditional cardiovascular disease (CVD) risk factors are related to long-term blood pressure change (BPC) or trajectories remain unclear. We aimed to examine the independent associations of these factors with 15-year BPC and trajectories in Chinese adults.
We included 15 985 participants who had attended three surveys, including 2004-2008 baseline survey, and 2013-2014 and 2020-2021 resurveys, over 15 years in the China Kadoorie Biobank (CKB). We measured systolic and diastolic blood pressure (SBP and DBP), height, weight, and waist circumference (WC). We asked about the sociodemographic characteristics and lifestyle factors, including smoking, alcohol drinking, intake of fresh vegetables, fruits, and red meat, and physical activity, using a structured questionnaire. We calculated standard deviation (SD), cumulative blood pressure (cumBP), coefficient of variation (CV), and average real variability (ARV) as long-term BPC proxies. We identified blood pressure trajectories using the latent class growth model.
Most baseline sociodemographic and lifestyle characteristics were associated with cumBP. After adjusting for other characteristics, the cumSBP (mmHg × year) increased by 116.9 [95% confidence interval (CI): 111.0, 122.7] for every 10 years of age. The differences of cumSBP in heavy drinkers of ≥60 g pure alcohol per day and former drinkers were 86.7 (60.7, 112.6) and 48.9 (23.1, 74.8) compared with less than weekly drinkers. The cumSBP in participants who ate red meat less than weekly was 29.4 (12.0, 46.8) higher than those who ate red meat daily. The corresponding differences of cumSBP were 127.8 (120.7, 134.9) and 70.2 (65.0, 75.3) for BMI per 5 kg/m 2 and WC per 10 cm. Most of the findings of other BPC measures by baseline characteristics were similar to the cumBP, but the differences between groups were somewhat weaker. Alcohol drinking was associated with several high-risk trajectories of SBP and DBP. Both BMI and WC were independently associated with all high-risk blood pressure trajectories.
Several traditional CVD risk factors were associated with unfavorable long-term BPC or blood pressure trajectories in Chinese adults.
传统心血管疾病（CVD）风险因素与长期血压变化（BPC）或轨迹之间的关系尚不清楚。我们旨在研究这些因素与中国成年人 15 年 BPC 和轨迹的独立关联。
我们纳入了 15985 名参与者，他们参加了三次调查，包括 2004-2008 年基线调查、2013-2014 年和 2020-2021 年复查，时间跨度为 15 年。在中国慢性病前瞻性研究（CKB）中，我们测量了收缩压和舒张压（SBP 和 DBP）、身高、体重和腰围（WC）。我们使用结构化问卷询问了社会人口统计学特征和生活方式因素，包括吸烟、饮酒、新鲜蔬菜、水果和红肉的摄入以及体力活动。我们计算了标准差（SD）、累积血压（cumBP）、变异系数（CV）和平均实际变异性（ARV）作为长期 BPC 的替代指标。我们使用潜在类别增长模型确定了血压轨迹。
大多数基线社会人口统计学和生活方式特征与 cumBP 相关。在调整其他特征后，每增加 10 岁，cumSBP（mmHg×年）增加 116.9[95%置信区间（CI）：111.0，122.7]。每天饮用≥60g 纯酒精的重度饮酒者和曾经饮酒者的 cumSBP 差异分别为 86.7（60.7，112.6）和 48.9（23.1，74.8），而每周饮酒少于一次的参与者为 48.9（23.1，74.8）。每周食用红肉少于一次的参与者的 cumSBP 比每天食用红肉的参与者高 29.4（12.0，46.8）。相应的 cumSBP 差异分别为 127.8（120.7，134.9）和 70.2（65.0，75.3），BMI 每增加 5kg/m2和 WC 每增加 10cm。大多数基于基线特征的其他 BPC 指标的发现与 cumBP 相似，但组间差异稍弱。饮酒与 SBP 和 DBP 的几种高危轨迹有关。BMI 和 WC 均与所有高危血压轨迹独立相关。
中国成年人的一些传统 CVD 风险因素与不利的长期 BPC 或血压轨迹有关。
