Does high‐normal blood pressure lead to excess cardiovascular disease events and deaths in Chinese people? A post‐hoc analysis of the 30‐year follow‐up of the Da Qing IGT and Diabetes Study

Abstract

AbstractAimWhether systolic/diastolic blood pressure (SBP/DBP) values of 130‐139/80‐89 mmHg should be defined as hypertension has been debated for decades. We aimed to characterize the effect of high‐normal BP on cardiovascular disease (CVD) events and deaths.MethodsIn total, 1726 individuals from the original Da Qing IGT and Diabetes Study were enrolled, and divided into the normal BP group (SBP <130 mmHg and DBP <80 mmHg), high‐normal BP group (SBP 130‐139 mmHg and/or DBP 80‐89 mmHg) and hypertension group (SBP ≥140 mmHg and/or DBP ≥90 mmHg). CVD events and their components were assessed from 1986 to 2016.ResultsDuring the 30‐year follow‐up, the high‐normal BP group was not at higher risk for CVD events [hazard ratio (HR) 1.05, 95% confidence interval (CI) 0.84‐1.30, p = .68], coronary heart disease (HR 1.12, 95% CI 0.77‐1.63, p = .57), stroke (HR 1.05, 95% CI 0.82‐1.34, p = .71), or CVD deaths (HR 1.15, 95% CI 0.82‐1.60, p = .41) compared with the normal BP group, after adjusting for covariates. However, the hypertension group exhibited significantly increased cardiovascular risk (CVD events, HR 1.91, 95% CI 1.48‐2.46, p < .0001; coronary heart disease, HR 1.73, 95% CI 1.12‐2.67, p = .01; stroke, HR 1.90, 95% CI 1.43‐2.52, p < .0001; CVD deaths, HR 2.07, 95% CI 1.43‐3.01, p = .0001) than the normal BP group. Subgroup analyses showed that, regardless of the presence of diabetes, high‐normal BP did not increase CVD events compared with normal BP.ConclusionsThis post‐hoc study provided no evidence that the high‐normal BP increased cardiovascular risk in the Da Qing study population, suggesting that it was reasonable to continue to define hypertension at 140/90 mmHg in China.