Association Between Blood Pressure Indicators and Stroke in Aged Population: A Community-Based Nested Case-Control Study

Abstract

Background and Aim

Any single discrete blood pressure (BP) measurement is not enough to estimate adverse cardiovascular events. We aim to comprehensively investigate the association between BP indicators and stroke.

Methods

An observational cohort study was conducted among 2888 Shanghai community-aged residents from 2014 to 2018, and a nested case-control study was designed to identify the association between BP indicators and stroke. In total 415 cases of stroke detected during the study period were selected as the case group and 415 non-stroke subjects, matched with factors of age and gender, were randomly selected from the cohort as control group.

Results

Multivariate logistic regression analysis revealed that systolic blood pressure (SBP) (adjusted odds ratio [AOR] 1.02, 95% confidence interval [CI] 1.02–1.03), pulse pressure (PP) (AOR 1.03, 95% CI 1.02–1.04), mean arterial pressure (MAP) (AOR1.02, 95% CI 1.01–1.04) and pulse pressure index (PPI) (AOR 25.68, 95% CI 3.19–206.90) increased the risk of stroke, respectively. After fitting both BP indicators and covariates, isolated abnormal SBP (AOR 2.55, 95% CI 1.74–3.72) or PP ≥50 mmHg (AOR 1.66, 95% CI 1.08–2.56) independently increased risk of stroke.

Conclusion

Besides SBP, PP and multiple factors, assessment should be taken into account comprehensively for stroke prevention and management.

Keywords:

• blood pressure; BP
• stroke
• nested case-control study
• primary care

Acknowledgments

This work was supported by the National Natural Science Foundation of China (grant no. 81872720) and Shanghai Municipal Commission of Health and Family Planning (grant no. 201840066) to Pro. Lijuan Zhang. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Data Sharing Statement

The data sets used and/or analyzed during the current study are available from the corresponding author upon request.

Disclosure

The authors report no conflicts of interest in this work.