Chen Quan, Du Jinling, Hong Xin
Department of Noncommunicable Disease Prevention, Nanjing Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Education, Wuxi No. 2 People's Hospital, Wuxi, Jiangsu, China.
Front Cardiovasc Med. 2024 Jul 24;11:1363266. doi: 10.3389/fcvm.2024.1363266. eCollection 2024.
This study aimed to characterize multivariate trajectories of blood pressure [systolic blood pressure (SBP) and diastolic blood pressure (DBP)] jointly and examine their impact on incident cardiovascular disease (CVD) among a Chinese elderly medical examination population.
A total of 13,504 individuals without CVD during 2018-2020 were included from the Chinese geriatric physical examination cohort study. The group-based trajectory model was used to construct multi-trajectories of systolic blood pressure and diastolic blood pressure. The primary outcome was the incidence of the first CVD events, consisting of stroke and coronary heart diseases, in 2021. The Cox proportional hazards model was used to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between BP multi-trajectories and incident CVD events.
We identified four blood pressure (BP) subclasses, summarized by their SBP and DBP levels from low to high as class 1 (7.16%), class 2 (55.17%), class 3 (32.26%), and class 4 (5.41%). In 2021, we documented 890 incident CVD events. Compared with participants in class 1, adjusted HRs were 1.56 (95% CI: 1.12-2.19) for class 2, 1.75 (95% CI: 1.24-2.47) for class 3, and 1.88 (95% CI: 1.24-2.85) for class 4 after adjustment for demographics, health behaviors, and metabolic index. Individuals aged 65 years and above with higher levels of BP trajectories had higher risks of CVD events in China.
Individuals with higher levels of both SBP and DBP trajectories over time were associated with an increased risk of incident CVD in the Chinese elderly population.
本研究旨在联合描述血压[收缩压（SBP）和舒张压（DBP）]的多变量轨迹，并探讨其对中国老年体检人群心血管疾病（CVD）发病的影响。
从中国老年人体检队列研究中纳入了2018年至2020年期间共13504例无CVD的个体。采用基于组的轨迹模型构建收缩压和舒张压的多轨迹。主要结局是2021年首次发生的CVD事件（包括中风和冠心病）的发生率。使用Cox比例风险模型计算血压多轨迹与CVD事件发生之间关联的风险比（HR）和95%置信区间（CI）。
我们识别出四个血压（BP）亚组，根据其SBP和DBP水平从低到高总结为1类（7.16%）、2类（55.17%）、3类（32.26%）和4类（5.41%）。2021年，我们记录了890例CVD事件。在对人口统计学、健康行为和代谢指数进行调整后，与1类参与者相比，2类参与者的调整后HR为1.56（95%CI：1.12 - 2.19），3类为1.75（95%CI：1.24 - 2.47），4类为1.88（95%CI：1.24 - 2.85）。在中国，65岁及以上且血压轨迹水平较高的个体发生CVD事件的风险更高。
随着时间推移，收缩压和舒张压轨迹水平较高的个体在中国老年人群中发生CVD事件的风险增加。
