Risk analysis of blood pressure changes on cardiovascular disease in Chinese population

The study aimed to assess the impact of changes in blood pressure on cardiovascular events in the Chinese population. It enrolled 33 179 Chinese participants aged ≥35 years (57.1% women) without CVD at baseline. BP status was defined according to the 2017 ACC/AHA hypertension guidelines. The type of BP change was defined as change in BP status from baseline to the end of follow-up, included stable BP <130/80, <130/80 to ≥130/80, ≥130/80 to <130/80 mm Hg, persistent BP ≥130/80 mm Hg. The hazard ratio (HR) of incident CVD by change in BP category was estimated using Cox proportional hazards and Fine-Gray models. During median follow-up of 3.17 years, 2023 CVD events occurred. Compared with BP <120/80, 120-129/<80 mm Hg at baseline (HR = 1.66, 95% CI: 1.09-2.53), 130-139/80-89 mm Hg (HR = 1.35, 95% CI: 0.94-1.95), and ≥140/90 mm Hg (HR = 2.46, 95% CI: 1.78-3.40) were risk factors for CVD. Compared with the group with stable BP <130/80 mm Hg, the risk of CVD was 1.88 (95% CI: 1.40-2.53) in the group with persistent BP ≥130/80 mm Hg and 1.40 (95% CI: 1.01-1.94) in the group of BP decreased to <130/80 mm Hg. These results showed that BP 120-129/<80, 130-139/80-89, and ≥140/90 mm Hg were associated with a high risk of CVD. Over time, persistent BP ≥130/80 mm Hg increased the risk of CVD, but a return to <130/80 mm Hg from hypertension decreased the risk of CVD.