[Association between hypertension subtypes and risk for all-cause mortality and cardio-cerebrovascular mortality in the elderly in communities of Beijing].

Abstract

Objective: To study the association between subtypes of hypertension and risk for all-cause mortality and cardio-cerebrovascular mortalities in the elderly in communities of Beijing. Methods: The data were collected from the Beijing Healthy Aging Cohort Study. The elderly in 5 urban areas (former Xicheng, former Xuanwu, Fangshan, Haidian and Tongzhou) and 4 rural areas (Yanqing, Miyun, Huairou and Daxing) in Beijing were selected as the study subjects by multi-stage stratified cluster random sampling. The baseline survey was conducted from July 2009 to September 2015. The follow-up was conducted until March 31, 2021, and a total of 6 326 participants were enrolled. Cox proportional hazard regression model was used to analyze the association of SBP, DBP, normal blood pressure, high normal blood pressure, simple systolic hypertension, simple diastolic hypertension and systolic diastolic hypertension with all-cause mortality and cardio-cerebrovascular mortality. Results: By March 31, 2021, the median follow-up time was 6.30 years, the all-cause mortality density was 201.67/10 000 person-years, and the cardio-cerebrovascular mortality density was 90.20/10 000 person-years. Multivariate Cox proportional hazard regression model analysis showed that the risk for all-cause mortality increased by 5.6% (HR=1.056, 95%CI: 1.020-1.092), and the risk for cardio-cerebrovasculvar mortality increased by 12.5% (HR=1.125, 95%CI: 1.071-1.182) for every 10 mmHg increase in SBP. The risk for all-cause mortality increased by 8.6% (HR=1.086, 95%CI: 1.023-1.152), and the risk for cardio-cerebrovascular mortality increased by 19.9% (HR=1.199, 95%CI: 1.101-1.306) for every 10 mmHg increase in DBP. Compared with the normal blood pressure group, the risk for all-cause mortality increased by 64.8% (HR=1.648, 95%CI: 1.049-2.591) and the risk for cardio- cerebrovascular mortality increased by 112.8% (HR=2.128, 95%CI: 1.069-4.233) in the simple diastolic hypertension group. The risk for all-cause mortality increased by 34.4% (HR=1.344, 95%CI: 1.023-1.467) and the risk for cardio-cerebrovascular mortality increased by 111.3% (HR=2.113, 95%CI: 1.384-3.225) in the systolic-diastolic hypertension group. Conclusions: In the elderly in communities of Beijing, beside systolic-diastolic hypertension. It is necessary to pay close attention to the simple diastolic hypertension, which has lower prevalence, and give targeted prevention and treatment.