Hypertension Subtype and Risk of Cardiovascular Disease in Chinese Adults

• Published in: Circulation (New York, N.Y.) Vol. 118; no. 15; pp. 1558 - 1566
• Main Authors: KELLY, Tanika N, DONGFENG GU, JING CHEN, HUANG, Jian-Feng, CHEN, Ji-Chun, XIUFANG DUAN, XIGUI WU, YAU, C. Lillian, WHELTON, Paul K, JIANG HE
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 07.10.2008
• Subjects: Adult; Age Distribution; Aged; Asian Continental Ancestry Group - statistics & numerical data; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Pressure; Cardiology. Vascular system; China - epidemiology; Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous; Female; Heart Diseases - ethnology; Heart Diseases - mortality; Humans; Hypertension - classification; Hypertension - ethnology; Hypertension - mortality; Incidence; Male; Medical sciences; Middle Aged; Prospective Studies; Risk Factors; Sex Distribution; Stroke - ethnology; Stroke - mortality; China; Hypertension; Chinese; Cardiovascular disease; cardiovascular diseases; relative risk; Risk factor
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circulationaha.107.723593

We examined the relationship between hypertension subtype and cardiovascular disease incidence and mortality in Chinese adults. We conducted a prospective cohort study in a nationally representative sample of 169 871 Chinese men and women aged >or=40 years. Data on systolic (SBP) and diastolic blood pressure (DBP) and other variables were obtained at a baseline examination in 1991 with the use of standard protocols. Follow-up evaluation was conducted in 1999-2000, with a response rate of 93.4%. Hypertension subtypes were defined as combined systolic and diastolic hypertension (SBP >or=140 and DBP >or=90 mm Hg), isolated systolic hypertension (SBP >or=140 and DBP <90 mm Hg), isolated diastolic hypertension (SBP <140 and DBP >or=90 mm Hg), and 2 categories of treated hypertension (SBP <140 and DBP <90 mm Hg or SBP >or=140 and/or DBP >or=90 mm Hg). After participants with missing BP values were excluded, 169 577 adults were included in the analyses. Compared with normotensives, relative risks (95% CIs) of cardiovascular disease incidence and mortality were 2.73 (2.60 to 2.86) and 2.53 (2.39 to 2.68) for combined systolic and diastolic hypertension, 1.78 (1.69 to 1.87) and 1.68 (1.58 to 1.78) for isolated systolic hypertension, 1.59 (1.43 to 1.76) and 1.45 (1.27 to 1.65) for isolated diastolic hypertension, 2.01 (1.64 to 2.48) and 1.61 (1.28 to 2.03) for treated hypertension with SBP <140 and DBP <90 mm Hg, and 3.37 (3.07 to 3.69) and 2.88 (2.60 to 3.19) for treated hypertension with SBP >or=140 and/or DBP >or=90 mm Hg, respectively, after adjustment for important covariables. Our results indicate that all hypertension subtypes are associated with significantly increased risk of cardiovascular disease in Chinese adults. Primary prevention of hypertension should be a public health priority in the Chinese population.