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. 2017 Feb 7:7:41969.
doi: 10.1038/srep41969.

Predictive Value of Cumulative Blood Pressure for All-Cause Mortality and Cardiovascular Events

Yan Xiu Wang  1   2 , Lu Song  2   3 , Ai Jun Xing  2 , Ming Gao  2 , Hai Yan Zhao  2 , Chun Hui Li  2   3 , Hua Ling Zhao  2   3 , Shuo Hua Chen  4 , Cheng Zhi Lu  1 , Shou Ling Wu  2
Affiliations

Predictive Value of Cumulative Blood Pressure for All-Cause Mortality and Cardiovascular Events

Yan Xiu Wang et al. Sci Rep. .

Abstract

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.

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Conflict of interest statement

The authors declare no competing financial interests.

Figures

Figure 1
Figure 1. The Survival Curve of the Study Population.
(A) All-cause mortality, (B) Cardiovascular and cerebrovascular events, (C) Myocardial infarction, and (D) Stroke.
Figure 2
Figure 2. The Relationship Between cumSBP and Endpoint Events in the Study Population.
(A) All-cause mortality, (B) Cardiovascular and cerebrovascular events, (C) Myocardial infarction, and (D) Stroke cumSBP, cumulative systolic blood pressure.
Figure 3
Figure 3. The Relationship Between cumDBP and Endpoint Events in the Study Population.
(A) All-cause mortality, (B) Cardiovascular and cerebrovascular events, (C) Myocardial infarction, and (D) Stroke cumDBP, cumulative diastolic blood pressure; Freq, frequency.
See this image and copyright information in PMC

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