Hypertension subtype and risk of cardiovascular disease in Chinese adults.
BACKGROUND
We examined the relationship between hypertension subtype and cardiovascular disease incidence and mortality in Chinese adults.


RESULTS
We conducted a prospective cohort study in a nationally representative sample of 169 871 Chinese men and women aged >or=40 years. Data on systolic (SBP) and diastolic blood pressure (DBP) and other variables were obtained at a baseline examination in 1991 with the use of standard protocols. Follow-up evaluation was conducted in 1999-2000, with a response rate of 93.4%. Hypertension subtypes were defined as combined systolic and diastolic hypertension (SBP >or=140 and DBP >or=90 mm Hg), isolated systolic hypertension (SBP >or=140 and DBP <90 mm Hg), isolated diastolic hypertension (SBP <140 and DBP >or=90 mm Hg), and 2 categories of treated hypertension (SBP <140 and DBP <90 mm Hg or SBP >or=140 and/or DBP >or=90 mm Hg). After participants with missing BP values were excluded, 169 577 adults were included in the analyses. Compared with normotensives, relative risks (95% CIs) of cardiovascular disease incidence and mortality were 2.73 (2.60 to 2.86) and 2.53 (2.39 to 2.68) for combined systolic and diastolic hypertension, 1.78 (1.69 to 1.87) and 1.68 (1.58 to 1.78) for isolated systolic hypertension, 1.59 (1.43 to 1.76) and 1.45 (1.27 to 1.65) for isolated diastolic hypertension, 2.01 (1.64 to 2.48) and 1.61 (1.28 to 2.03) for treated hypertension with SBP <140 and DBP <90 mm Hg, and 3.37 (3.07 to 3.69) and 2.88 (2.60 to 3.19) for treated hypertension with SBP >or=140 and/or DBP >or=90 mm Hg, respectively, after adjustment for important covariables.


CONCLUSIONS
Our results indicate that all hypertension subtypes are associated with significantly increased risk of cardiovascular disease in Chinese adults. Primary prevention of hypertension should be a public health priority in the Chinese population.
Kelly
Tanika N
TN
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
Gu
Dongfeng
D
Chen
Jing
J
Huang
Jian-feng
JF
Chen
Ji-chun
JC
Duan
Xiufang
X
Wu
Xigui
X
Yau
C Lillian
CL
Whelton
Paul K
PK
He
Jiang
J
D000328:Adult; D017677:Age Distribution; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D001794:Blood Pressure; D002681:China / Q000453:epidemiology; D005260:Female; D006331:Heart Diseases / Q000208:ethnology* / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000145:classification* / Q000208:ethnology* / Q000401:mortality; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D020521:Stroke / Q000208:ethnology* / Q000401:mortality