The association between changes in blood pressure components and incident cardiovascular diseases

Figures & data

Figure 1. Outline of the selection design of study participants. SBP: systolic blood pressure, DBP: diastolic blood pressure, 2h-PCG: 2-hour post challenge plasma glucose, FPG: fasting plasma glucose, CVD: cardiovascular disease.

Table 1. Comparison of baseline characteristics between respondents and non-respondents.

	Respondents (N = 3569)	Non-respondents(N = 1099)	p-value
Continuous variables
Age, year	46.41 (11.66)	49.86 (12.94)	<0.001
Body mass index (kg/m^2)	27.52 (4.35)	28.0 (4.66)	0.003
Systolic blood pressure (mmHg)	120.44 (18.64)	125.74 (20.99)	<0.001
Diastolic blood pressure (mmHg)	78.83 (10.54)	80.31 (11.08)	<0.001
Pulse pressure (mmHg)	42.22 (13.9)	38.56 (20.21)	<0.001
Mean arterial pressure (mmHg)	92.70 (12.22)	95.45 (13.11)	<0.001
Total Cholesterol (mmol L^−1)	5.58 (1.13)	5.79 (1.26)	<0.001
Triglycerides^a (mmol L^−1)	1.75 (1.25)	2.0 (1.53)	<0.001
High density lipoprotein cholesterol (mmol L^−1)	1.09 (0.28)	1.08 (0.28)	0.63
Fasting plasma glucose (mmol L^−1)	5.15 (0.82)	7.06 (3.46)	<0.001
2-h post challenge plasma glucose (mmol L^−1)	6.55 (2.59)	8.35 (5.34)	<0.001
Estimated glomerular filtration rate (ml/min/1.73m^2)	68.53 (10.55)	66.79 (11.54)	<0.001
Categorical variables
Female, n (%)	2048 (57.3)	641 (62.0)	0.007
Family history of cardiovascular disease
Father	282 (7.9)	76 (7.4)	0.57
Mother	375 (10.5)	94 (9.1)	0.19
Current smokers, n (%)	485 (13.6)	128 (13.5)	0.93
Education, n (%)			<0.001
<6 y	1458 (40.8)	1713 (47.9)
6–12 y	517 (50.4)	419 (40.8)
≥12y	404 (11.3)	90 (8.8)
Diabetes, n (%)	89 (2.5)	346 (34.1)	<0.001
Hypercholesterolemia, n (%)	983 (27.5)	443 (40.7)	<0.001
Medication use, n (%)
Hypertension drugs	233 (6.5)	116 (11.2)	<0.001
Lipid drugs	93 (2.6)	79 (7.6)	<0.001
Diabetes drugs	3 (0.1)	183 (17.7)	<0.001

Mean (SD) was shown for continuous variables and p-value was calculated with t-test; n (%) was shown for categorical variables with p-value according to chi-square or Fisher exact test as appropriate and Wilcoxon signed-rank test for ordered data; a. triglyceride was shown as median (inter-quartile range) and p-value according to Man-Whitney U test.

Table 2. Blood pressure parameters’ changing values (n = 3569) between 1999–2001 and 2002–2005.

	Changing value	1st tertile	2nd tertile	3rd tertile
SBP change	−1.43 (13.8)	−14.9 (8.9)	−1.05 (2.46)	13.0 (8.6)
DBP change	−2.68 (9.14)	−11.9 (5.35)	−2.0 (1.96)	7.56 (5.11)
PP change	1.26 (11.19)	−10.05 (6.86)	1.81 (2.46)	13.62 (6.67)
MAP change	−2.27 (9.56)	−12.39 (5.7)	−2.03 (2.14)	7.9 (5.6)

Data are shown as mean (SD).

Systolic Blood Pressure (SBP); Diastolic Blood Pressure (DBP); Pulse Pressure (PP); Mean Arterial Pressure (MAP).

Figure 2. Multivariate Cox proportional hazard analysis of 1 SD increase in the change of different blood pressure components between 1999–2001 and 2002–2005, for incident cardiovascular diseases^a. Model I: baseline measurements of gender, age and the main exposure; model II: Model I + baseline value of related blood pressure measurement; model III: Model II + baseline measurements of DBP/SBP, family history of CVD, eGFR, BMI, waist circumference, diabetes mellitus, hypertension drugs, current smoking, hypercholesterolemia and education level; model IV (only for SBP and DBP change): model III + changing value of SBP or DBP as appropriate. a: 1 SD change of SBP change: 13.8 mm Hg; 1 SD change of DBP change: 9.14 mm Hg; 1 SD change of PP change: 12.9 mm Hg and 1 SD change of MAP change: 9.5 mm Hg; systolic blood pressure (SBP); diastolic blood pressure (DBP); pulse pressure (PP); mean arterial pressure (MAP); body mass index (BMI); estimated glomerular filtration rate (eGFR); main exposures: SBP change, DBP change, MAP change and PP change.

Table 3. Hazard ratios for predicting cardiovascular disease in different models of systolic/diastolic blood pressure, pulse pressure and mean arterial pressure change with respect to changing tertiles^a.

	1(lowest)	2	3(highest)	P trend	Harrell's C	AIC
SBP change	<-5	−5 to 3.499	≥3.5
Event/Number of subjects	118/1300	80/1085	105/1184	–	–	–
Model I	Reference	0.97 (0.73–1.29)	0.97 (0.74–1.26)	0.86	0.75	4641
Model II	Reference	1.13 (0.84–1.51)	1.21 (0.92–1.60)	0.17	0.76	4620
Model III	Reference	1.10 (0.82–1.48)	1.13 (0.85–1.49)	0.4	0.76	4601
Model IV	Reference	1.03 (0.76–1.40)	0.98 (0.72–1.35)	0.93	0.76	4601
DBP change	<-5	−5 to 1.99	≥2
Event/Number of subjects	117/1311	94/1156	92/1102	–	–	–
Model I	Reference	1.03 (0.78–1.35)	1.08 (0.82–1.42)	0.57	0.76	4641
Model II	Reference	1.26 (0.95–1.68)	1.45 (1.08–1.94)	0.01	0.76	4611
Model III	Reference	1.2 (0.9–1.59)	1.36 (1.01–1.83)	0.04	0.76	4597
Model IV	Reference	1.2 (0.89–1.61)	1.37 (0.98–1.9)	0.06	0.76	4601
PP change	<-3	−3 to 6.99	≥7
Event/Number of subjects	103/1218	113/1221	87/1130	–	–	–
Model I	Reference	1.16(0.88–1.53)	1.03(0.78–1.35)	0.81	0.76	4634
Model II	Reference	1.29(0.97–1.72)	1.19(0.89–1.6)	0.24	0.76	4635
Model III	Reference	1.27(0.95–1.7)	1.14(0.85–1.53)	0.39	0.76	4607
MAP change	<-5.66	−5.67 to 1.66	≥1.67	–	–	–
Event/Number of subjects	115/1204	85/1195	103/1170	–	–	–
Model I	Reference	0.85 (0.64–1.12)	1.01 (0.77–1.32)	0.96	0.76	4639
Model II	Reference	1.04 (0.78–1.39)	1.32 (1.0–1.75)	0.056	0.76	4612
Model III	Reference	1.0 (0.74–1.34)	1.26 (0.95–1.68)	0.11	0.76	4596

Model I: baseline measurements of gender, age and main exposure change; Model II: Model I +baseline value of related blood pressure measurement; Model III: Model II +baseline measurements of DBP/SBP, Family history of CVD of CVD, GFR, BMI, waist, Diabetes mellitus, hypertension drugs, current smoking, hypercholesterolemia and education level; model IV (only for SBP and DBP change): model III + SBP change and DBP change as appropriate.

AIC: Akaike Information Criterion.

Systolic Blood pressure (SBP); Dyastolic Blood pressure (DBP); pulse pressure (PP); Mean Arterial pressure (MAP); body mass index (BMI); Estimated Glomerular filtration rate (eGFR).

Main exposures: SBP change, DBP change, MAP change and PP change.

^a Significant variables are presented in bold.