Background The association between pulse pressure (PP) and the risk of first ischaemic stroke (IS) is inconsistent. Therefore, we evaluated the association between PP and the risk of first IS among elderly hypertensive population in China.
Methods This was a retrospective cohort study. Patients with hypertension and aged ≥60 years were recruited. Multivariate Cox regression was performed to evaluate the association between PP and the risk of IS. We further stratified the regression models into subgroups and test for interaction to assess whether the associations were modified by other covariates.
Results A total of 3315 patients with hypertension (44.49% male; mean age 71.41±7.20 years) were included, and 206 cases of IS occurred with a median follow-up of 5.5 years. The results showed that per SD mm Hg increment in PP was associated with a 17% (95% CI 1.05 to 1.40, p=0.0172) increased risk of IS. Moreover, the HR of IS for the highest quartile of PP was 1.46 (95% CI 1.18 to 1.73, p=0.0011, p for trend <0.001) comparing with the lowest quartile of PP. Subgroup analysis showed that population aged ≥70 years, male, patients with smoking or drinking habit, diabetes at baseline, being overweight, with uncontrolled blood pressure or did not take antihypertensive drugs have a higher risk for IS.
Conclusions We found that PP was significantly associated with IS and was an independent risk factor for IS.
Statistics from Altmetric.com
Contributors JH contributed to the drafting of the manuscript. LL, Y-LY, C-LC, BZ and S-tT collected the data. KL and Y-QH analysed and interpreted the data. YQF contributed to the conception and critical revision of the manuscript. All authors read and approved the final manuscript.
Funding This work was supported by the Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention (No. 2017B030314041), the Science and Technology Program of Guangzhou (No. 201604020143, No. 201604020018, No. 201604020186, No. 201510010254 and No. 201803040012), the Medical Science and Technology Research Fund of Guangdong Province (No. B2018023), the National Key Research and Development Program of China (No. 2017FYC1307603, No. 2016YFC1301305 and No. 2017YFC0909303) and the Key Area R&D Program of Guangdong Province (No. 2019B020227005).
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval This study was in compliance with the principles outlined in the Declaration of Helsinki and was approved by the institutional medical ethical committee of the Guangdong Provincial People’s Hospital, Guangzhou, China. Written informed consent was obtained from all participants in the study.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.