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. 2019 Nov 20;19(1):258.
doi: 10.1186/s12872-019-1197-x.

Elevated blood pressure level based on 2017 ACC/AHA guideline in relation to stroke risk in rural areas of Liaoning province

Yanxia Xie  1 , Mingfeng Ma  2 , Zhao Li  3 , Xiaofan Guo  3 , Guozhe Sun  3 , Zhaoqing Sun  4 , Jia Zheng  1 , Yingxian Sun  5 , Liqiang Zheng  6
Affiliations

Elevated blood pressure level based on 2017 ACC/AHA guideline in relation to stroke risk in rural areas of Liaoning province

Yanxia Xie et al. BMC Cardiovasc Disord. .

Abstract

Background: The new ACC/AHA hypertension guideline lower the definition of hypertension from 140/90 mmHg to 130/80 mmHg and eliminate the category of prehypertension thus increasing the prevalence of hypertension. A purpose of this study is to explore the applicability of the new guidelines in rural China.

Methods: In total, 3229 participants aged ≥35 years and free of stroke at baseline were followed for up to 4.8 years during 2012 to 2017 in a rural community-based prospective cohort study of Xifeng County. The hazard ratio (HR) and 95% Confidence interval (CI) of different blood pressure (BP) levels for risk of incident stroke were analyzed by multivariable Cox proportional hazard models.

Results: During the follow-up, 81 new strokes occurred among the 3229 participants. Compared with normal BP (Systolic BP (SBP)<120 mmHg and Diastolic BP (DBP)<80 mmHg), stage 2 hypertension (SBP ≥ 140 mmHg or DBP ≥ 90 mmHg) had approximately 2.1 greater risks for stroke (HR: 2.10, 95% CI: 1.13 to 3.91, P = 0.020). However, there was no significant association between elevated (SBP:120-129 mmHg and DBP<80 mmHg), stage1 hypertension (SBP:130-139 mmHg or DBP:80-89 mmHg) and stroke incidence (HR: 0.93, 95% CI: 0.33 to 2.61, P = 0.888; HR: 0.96, 95% CI: 0.46 to 2.02, P = 0.920, respectively). An increase of the SBP by 1-SD increases the risk for stroke by 56% (HR: 1.56, 95%CI: 1.29 to 1.88, P < 0.001). An increase of the SBP by 20 mmHg increases the risk for stroke by 51% (HR: 1.51, 95%CI: 1.27 to 1.80, P < 0.001).

Conclusions: Compared with normal BP, the stage 2 hypertension based on 2017 ACC/AHA guideline significantly increases the risk of stroke incidence, but this association was not observed between elevated, stage1 hypertension and stroke incidence in Chinese rural adults.

Keywords: Blood pressure; Incidence; Prospective study; Rural area; Stroke.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of participant recruitment and derivation of the population used in the final analysis. Abbreviation: SBP, systolic blood pressure; DBP, diastolic blood pressure
Fig. 2
Fig. 2
Incidence rate of stroke (per 100,000 person-years) in different BP level between women and men. Abbreviation: the digital on top of the bars represent the number of stroke events
See this image and copyright information in PMC

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References

    1. Egan BM, Li J, Hutchison FN, Ferdinand KC. Hypertension in the United States, 1999 to 2012: progress toward healthy people 2020 goals. Circulation. 2014;130(19):1692–1699. doi: 10.1161/CIRCULATIONAHA.114.010676. - DOI - PMC - PubMed
    1. Ford ES. Trends in mortality from all causes and cardiovascular disease among hypertensive and non-hypertensive adults in the United States. Circulation. 2011;123(16):1737–1744. doi: 10.1161/CIRCULATIONAHA.110.005645. - DOI - PubMed
    1. Cheng S, Claggett B, Correia AW, Shah AM, Gupta DK, Skali H, et al. Temporal trends in the population attributable risk for cardiovascular disease: the atherosclerosis risk in communities study. Circulation. 2014;130(10):820–828. doi: 10.1161/CIRCULATIONAHA.113.008506. - DOI - PMC - PubMed
    1. He J, Gu D, Wu X, Reynolds K, Duan X, Yao C, et al. Major causes of death among men and women in China. N Engl J Med. 2005;353(11):1124–1134. doi: 10.1056/NEJMsa050467. - DOI - PubMed
    1. Zhao D, Liu J, Wang W, Zeng Z, Cheng J, Liu J, et al. Epidemiological transition of stroke in China: twenty-one-year observational study from the Sino-MONICA-Beijing project. Stroke. 2008;39(6):1668–1674. doi: 10.1161/STROKEAHA.107.502807. - DOI - PubMed

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