Cho So Mi J, Urbut Sarah, Ruan Yunfeng, Bhatnagar Aarushi, Ganesh Shriienidhie, Hornsby Whitney E, Bhattacharya Romit, Honigberg Michael C, Juraschek Stephen P, Yang Eugene, Shimbo Daichi, Natarajan Pradeep
Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA (S.M.J.C., S.U., Y.R., W.E.H., R.B., M.C.H., P.N.).
Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston (S.M.J.C., S.U., Y.R., A.B., S.G., W.E.H., R.B., M.C.H., P.N.).
Hypertension. 2025 Mar;82(3):520-531. doi: 10.1161/HYPERTENSIONAHA.124.23985. Epub 2025 Feb 12.
Cardiovascular disease (CVD) risk differs across Asian subgroups, possibly due to differences in hypertension burden. We characterized lifetime blood pressure (BP) trajectories for East and South Asian individuals and compared their associations with CVD risk.
Among 148 872 UK Biobank participants with primary care utilization data, life course BP trajectories were fitted as a function of age by sex according to self-identified ethnicity. We determined associations of time-averaged young adulthood (18-39 years), middle age (40-64 years), and later life (≥65 years) systolic BP (SBP) and diastolic BP with incident atherosclerotic CVD risk.
The predicted SBP/diastolic BP (95% CI) at age 30 years was 108 (103-114)/68 (65-71) mm Hg for East Asian and 114 (110-118)/72 (71-73) mm Hg for South Asian individuals. By age 40, South Asian individuals were projected to reach an SBP of 130.0 mm Hg, whereas East Asian individuals reached the equivalent SBP by age 49 years. Among South Asian individuals, each SD increase in young adulthood SBP was associated with a higher atherosclerotic CVD risk with an odds ratio (95% CI) of 1.41 (1.12-1.75), but not among East Asians (=0.01). Midlife SBP was associated with peripheral artery disease among South Asian individuals (odds ratio, 2.08 [95% CI, 1.51-2.88]) and with ischemic stroke among East Asian individuals (odds ratio, 3.84 [95% CI, 1.08-5.07]). Later-life SBP was associated with myocardial infarction risk by 1.52 (1.15-1.92)-fold among South Asians and ischemic stroke by 2.50 (1.06-3.80)-fold among East Asian individuals.
East and South Asian individuals exhibit distinct BP trajectories that age-differentially associate with incident CVD. Disaggregating Asian subgroups may inform tailored hypertension screening and management.
心血管疾病（CVD）风险在亚洲不同亚组中存在差异，这可能归因于高血压负担的不同。我们对东亚和南亚个体的终生血压（BP）轨迹进行了特征描述，并比较了它们与CVD风险的关联。
在148872名有初级医疗利用数据的英国生物银行参与者中，根据自我认定的种族，将生命历程中的BP轨迹拟合为年龄和性别的函数。我们确定了青年期（18 - 39岁）、中年期（40 - 64岁）和老年期（≥65岁）的平均收缩压（SBP）和舒张压与动脉粥样硬化性CVD发病风险之间的关联。
东亚个体30岁时预测的收缩压/舒张压（95%CI）为108（103 - 114）/68（65 - 71）mmHg，南亚个体为114（110 - 118）/72（71 - 73）mmHg。到40岁时，预计南亚个体的收缩压达到130.0mmHg，而东亚个体在49岁时达到相同的收缩压。在南亚个体中，青年期SBP每增加1个标准差与动脉粥样硬化性CVD风险升高相关，优势比（95%CI）为1.41（1.12 - 1.75），但在东亚个体中并非如此（P = 0.01）。中年期SBP与南亚个体的外周动脉疾病相关（优势比，2.08 [95%CI，1.51 - 2.88]），与东亚个体的缺血性中风相关（优势比，3.84 [95%CI，1.08 - 5.07]）。老年期SBP与南亚个体的心肌梗死风险增加1.52（1.15 - 1.92）倍相关，与东亚个体的缺血性中风风险增加2.50（1.06 - 3.80）倍相关。
东亚和南亚个体表现出不同的BP轨迹，这些轨迹与CVD发病在年龄上存在差异关联。区分亚洲亚组可能有助于进行针对性的高血压筛查和管理。
