Sex-Specific Association of Blood Pressure Categories With All-Cause Mortality: The Rural Chinese Cohort Study

Liu, Leilei; Wang, Bingyuan; Liu, Xincan; Ren, Yongcheng; Zhao, Yang; Liu, Dechen; Zhou, Jun‐Mei; Liu, Xuejiao; Zhang, Dongdong; Xu, Chao; Cheng, Cheng; Liu, Feiyan; Zhou, Qionggui; Li, Jianxin; Cao, Jie; Chen, Jichun; Huang, Jianfeng; Zhang, Ming; Hu, Dongsheng

doi:10.5888/pcd17.190131

Cited by 3 publications

(1 citation statement)

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“…The positive associations have been repeatedly reported between hypertension with cardiovascular incidence and total mortality among young or middle-aged adults (20,(26)(27)(28)(29)(30). This is consistent with our study using the traditional BP threshold for hypertension (140/90 mmHg).…”

Section: Discussionsupporting

confidence: 93%

Similarities in Hypertension Status but Differences in Mortality Risk: A Comparison of 2017 ACC/AHA and 2018 Chinese Hypertension Guidelines

Chen

Sheng

Wang

et al. 2022

Front. Cardiovasc. Med.

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BackgroundFew studies investigated the concordance in hypertension status and antihypertensive treatment recommendations between the 2018 Chinese Hypertension League (CHL) guidelines and the 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines and assessed the change of premature mortality risk with hypertension defined by the ACC/AHA guidelines.MethodsWe used the baseline data of the China Health and Retirement Longitudinal Study (CHARLS) to estimate the population impact on hypertension management between CHL and ACC/AHA guidelines. Mortality risk from hypertension was estimated using the data from China Health and Nutrition Survey (CHNS). Cox proportional hazards model was used to estimate the hazard ratios (HRs) and their 95% confidence intervals(CIs).ResultsAmong 13,704 participants analyzed from the nationally representative data of CHARLS, 42.64% (95% CI: 40.35, 44.96) of Chinese adults were diagnosed by both CHL and ACC/AHA guidelines. 41.25% (39.17, 43.36) did not have hypertension according to either guideline. Overall, the concordance in hypertension status was 83.89% (81.69, 85.57). A high percentage of agreement was also found for recommendation to initiate treatment among untreated subjects (87.62% [86.67, 88.51]) and blood pressure (BP) above the goal among treated subjects (71.68% [68.16, 74.95]). Among 23,063 adults from CHNS, subjects with hypertension by CHL had a higher risk of premature mortality (1.75 [1.50, 2.04]) compared with those without hypertension. The association diminished for hypertension by ACC/AHA (1.46 [1.07, 1.30]). Moreover, the excess risk was not significant for the newly defined Grade 1 hypertension by ACC/AHA (1.15 [0.95, 1.38]) when compared with BP <120/80 mmHg. This contrasted with the estimate from CHL (1.54 [1.25, 1.89]). The same pattern was observed for total mortality.ConclusionsIf ACC/AHA guidelines were adopted, a high degree of concordance in hypertension status and initiation of antihypertensive treatment was found with CHL guidelines. However, the mortality risk with hypertension was reduced with a non-significant risk for Grade 1 hypertension defined by the ACC/AHA.

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