Age and gender difference in blood pressure associations with cardiovascular outcomes and diabetes: a national population-based cohort study

Abstract

Abstract Objective We aim to analyze the age and gender difference in blood pressure(BP) associations with cardiovascular outcomes and diabetes in middle aged and elderly Chinese population. Method We included a total of 4,405 adults aged 40–80 years from the China Health and Nutrition Survey (CHNS) cohort. Cox proportional hazards regression models were used to estimate hazard ratios and 95% CIs. Restricted cubic spline analyses were used to explore linear and nonlinear relationships of BP with disease risk. Result With a mean follow-up of 12.2 years, 627 individuals progressed to at least one condition. Multivariable adjusted Cox models showed a strong positive association between BP and cardiovascular outcomes. Each 10 mm Hg higher usual systolic BP was significantly associated with myocardial infarction(MI)(HR[95%CI]: 1.16[1.07–1.27]), stroke(HR[95%CI]: 1.31[1.23–1.40]), and diabetes(HR[95%CI]: 1.1[1.03–1.17]). In subgroup analysis, BP was strongly associated with cardiovascular outcomes in young age group and associated with diabetes in female individuals. Conclusion BP was more strongly associated with stroke than with MI and diabetes. The strength of these associations declined with increasing age. Besides, either systolic BP or diastolic BP was more strongly associated with diabetes in female individuals than male individuals.