Abstract
The patterns of blood pressure trajectory (i.e., change over time) over life-course remain to be explored. In this study, we aim to determine the trajectories of systolic blood pressure (SBP) from adulthood to late life and to assess its impact on the risk of cardiovascular diseases (CVDs). Based on the China Health and Nutrition Survey, a total of 3566 participants aged 20-50 years at baseline (1989) with at least three SBP measurements during 1989-2011 were included. SBP was measured through physical examination, and socio-demographic factors, lifestyles, medications, and CVDs were based on self-reported questionnaire. Latent class growth modeling was performed to examine SBP trajectory. Odds ratio (OR) and 95% confidence interval (CI) from logistic regression was used to determine the association between SBP trajectory and CVDs. Five trajectory groups of SBP were identified: Class 1: rapid increase (n = 113, 3.2%); Class 2: slight increase (n = 1958, 54.9%); Class 3: stable (n = 614, 17.2%); Class 4: increase (n = 800, 22.4%); Class 5: fluctuant (n = 81, 2.3%). After adjustment of demographic factors, baseline SBP, and lifestyles, compared with the "slight increase" group, the OR (95% CI) of CVDs was 0.65 (0.32, 1.28) for "stable" group, 2.24 (1.40, 3.58) for "increase" group, 3.95 (1.81, 8.62) for "rapid increase" group, and 4.32 (1.76, 10.57) for "fluctuant" group. After stratified by use of antihypertensive drugs, the association was only significant for "rapid increase" group among those using antihypertensive drugs with OR (95% CI) of 2.81 (1.01, 7.77). Having a rapidly increasing SBP over life-course is associated with a higher risk of CVDs. This implies the importance of monitoring lifetime change of blood pressure for the prevention of CVDs.
Highlights
Previous studies on the association between high blood pressure and cardiovascular diseases (CVDs) have normally measured blood pressure at one occasion [1,2,3] or several occasions in a specific life period [4, 5]
Odds ratio (OR) and 95% confidence interval (CI) from logistic regression was used to determine the association between systolic blood pressure (SBP) trajectory and CVDs
Life-course systolic blood pressure trajectory available to the research community upon approval by the China Health and Nutrition Survey (CHNS) data management and maintenance committee. Applications for accessing these data can be submitted to the committee through filling in an online registration form
Summary
Previous studies on the association between high blood pressure and cardiovascular diseases (CVDs) have normally measured blood pressure at one occasion [1,2,3] or several occasions in a specific life period [4, 5]. There is little evidence about the patterns of blood pressure trajectory over lifecourse and their impacts on CVDs. The patterns of blood pressure trajectory (i.e., change over time) over life-course remain to be explored. We aim to determine the trajectories of systolic blood pressure (SBP) from adulthood to late life and to assess its impact on the risk of cardiovascular diseases (CVDs)
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