Cardiovascular risk of isolated systolic hypertension in young-to-middle-aged adults in China: A prospective cohort study
Hao Wang, Ying Zhang, Jiansong Yuan, Xin Du, Qiaoyu Shao, Shicheng Li, Mengying Zeng, Shouling Wu, Weixian Yang, Xiaowei YanAbstract
Background:
The clinical significance of isolated systolic hypertension (ISH) among young-to-middle-aged adults remains controversial. This study aimed to investigate the association between ISH and cardiovascular disease (CVD) risk in individuals aged 18–49 years.
Methods:
Our study included 73,552 Kailuan cohort participants aged 18–49 years without a history of CVD and who were not taking antihypertensive medications between 2006 and 2013. The primary outcome was the occurrence of composite CVD events, including stroke, heart failure (HF), and myocardial infarction (MI). The participants were categorized into five groups by baseline blood pressure (BP): normal, high-normal, ISH, isolated diastolic hypertension (IDH), and systolic-diastolic hypertension (SDH).
Results:
Of the 73,552 participants, 1775 (2.4%) had ISH. Over a median follow-up of 12.1 years, 102 composite CVD events were documented in patients with ISH. Individuals with ISH exhibited a significantly higher risk of CVD than those in the normal group (Hazard eratio [HR], 2.10, 95% confidence interval [CI], 1.67–2.65). The CVD risk remained lower in the high-normal and IDH groups than in the ISH group, whereas SDH conferred a greater risk. Compared to the normal group, the risk of stroke (HR, 2.41, [95% CI, 1.92–3.20]) and HF (HR, 1.89, [95% CI, 1.16–3.08]) were significantly increased in the ISH group, whereas the risk of MI was not (HR, 1.17, [95% CI, 0.63–2.17]).
Conclusions:
In Chinese young-to-middle-aged adults, ISH was associated with a significantly higher risk of CVD events than those with normal BP.
Clinical trial registration
ChiCTR-TNRC-11001489 (Chinese Clinical Trial Registry).