Predictive Value of Cumulative Blood Pressure for All-Cause Mortality and Cardiovascular Events.
The predictive value of cumulative blood pressure (BP) on all-cause mortality and cardiovascular and cerebrovascular events (CCE) has hardly been studied. In this prospective cohort study including 52,385 participants from the Kailuan Group who attended three medical examinations and without CCE, the impact of cumulative systolic BP (cumSBP) and cumulative diastolic BP (cumDBP) on all-cause mortality and CCEs was investigated. For the study population, the mean (standard deviation) age was 48.82 (11.77) years of which 40,141 (76.6%) were male. The follow-up for all-cause mortality and CCEs was 3.96 (0.48) and 2.98 (0.41) years, respectively. Multivariate Cox proportional hazards regression analysis showed that for every 10 mm Hg·year increase in cumSBP and 5 mm Hg·year increase in cumDBP, the hazard ratio for all-cause mortality were 1.013 (1.006, 1.021) and 1.012 (1.006, 1.018); for CCEs, 1.018 (1.010, 1.027) and 1.017 (1.010, 1.024); for stroke, 1.021 (1.011, 1.031) and 1.018 (1.010, 1.026); and for MI, 1.013 (0.996, 1.030) and 1.015 (1.000, 1.029). Using natural spline function analysis, cumSBP and cumDBP showed a J-curve relationship with CCEs; and a U-curve relationship with stroke (ischemic stroke and hemorrhagic stroke). Therefore, increases in cumSBP and cumDBP were predictive for all-cause mortality, CCEs, and stroke.
Department of Cardiology, Tianjin First Center Hospital, Clinical Medical College of Tianjin Medical University, Tianjin, China.|Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
Yan Xiu
YX
Wang
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.|Graduate school, North China University of Science and Technology, Tangshan, China.
Lu
L
Song
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
Ai Jun
AJ
Xing
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
Ming
M
Gao
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
Hai Yan
HY
Zhao
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.|Graduate school, North China University of Science and Technology, Tangshan, China.
Chun Hui
CH
Li
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.|Graduate school, North China University of Science and Technology, Tangshan, China.
Hua Ling
HL
Zhao
Department of Health Care Center, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
Shuo Hua
SH
Chen
Department of Cardiology, Tianjin First Center Hospital, Clinical Medical College of Tianjin Medical University, Tianjin, China.
Cheng Zhi
CZ
Lu
Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
Shou Ling
SL
Wu
D000328:Adult; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000401:mortality* / Q000473:pathology; D016022:Case-Control Studies; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate