Open AccessLife-course blood pressure trajectories and cardiovascular diseases: A population-based cohort study in China
Author(s) -
Yongshi Xu,
Jette Möller,
Rui Wang,
Yajun Liang
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0240804
Subject(s) - confidence interval , medicine , odds ratio , blood pressure , logistic regression , cohort , cohort study , life course approach , demography , population , latent class model , gerontology , environmental health , psychology , social psychology , statistics , mathematics , sociology
Background 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). Methods 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. Results 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). Conclusions 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.