Adults with SBP increase over time at higher risk for CVD, stroke

A slow increase in systolic blood pressure (SBP) trajectory has been observed over a follow-up period of nearly 7 years among adults aged 50‒70 years and who are not receiving any antihypertensive agent, a study has shown.

However, individuals whose SBP increased from low and moderate levels demonstrate elevated risks for cardiovascular disease (CVD).

A total of 8,969 adult participants without CVD at baseline and not taking antihypertensive medication throughout the study were included in the analysis. The investigators identified BP trajectories using a latent class mixed model and four timepoints data from the Guangzhou Biobank Cohort Study. They then assessed the association of BP trajectories with fatal and nonfatal CVD using Cox regression.

The following SBP trajectories were identified: “low slow increase,” characterized by SBP from 110 to 125 mm Hg (86.5 percent); “low increase” from 110 to 150 mm Hg (8.1 percent); and “moderate increase” from 125 to 155 mm Hg (5.4 percent).

Participants in the moderate-increase group showed the highest risk of CVD (hazard ratio [HR], 1.76, 95 percent confidence interval [CI], 1.34‒2.29), ischaemic heart disease (HR, 1.77, 95 percent CI, 1.01‒3.09), myocardial infarction (HR, 3.52, 95 percent CI, 1.58‒7.85), all strokes (HR, 1.88, 95 percent CI, 1.37‒2.60), ischaemic stroke (HR, 1.65, 95 percent CI, 1.10‒2.49), haemorrhagic stroke (HR, 3.98, 95 percent CI, 1.30‒12.12), and CVD mortality (HR, 2.41, 95 percent CI, 1.55‒3.76) relative to those in the low-slow-increase group.

The low-increase group also showed higher risk of CVD (HR, 1.27, 95 percent CI, 1.01‒1.61) and ischaemic stroke (HR, 1.49, 95 percent CI, 1.07‒2.09).