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Association of pulse pressure with all-cause mortality in young adults
  1. Jie LI1,
  2. Jia-Yi Huang1,
  3. Kenneth Lo2,
  4. Bin Zhang1,
  5. Yu-Qing Huang1,
  6. Ying Qing Feng1
  1. 1Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, Guangzhou, China
  2. 2Department of Epidemiology, Centre for Global Cardiometabolic Health, Brown University, Providence, Rhode Island, USA
  1. Correspondence to Professor Ying Qing Feng, Department of Cardiology, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Provincial People's Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, South China University of Technology School of Medicine, 510080 Guangzhou, China; 651792209{at}qq.com

Abstract

Background Pulse blood pressure was significantly associated with all-cause mortality in middle-aged and elderly populations, but less evidence was known in young adults.

Objective To assess the association of pulse pressure (PP) with all-cause mortality in young adults.

Methods This cohort from the 1999–2006 National Health and Nutrition Examination Survey included adults aged 18–40 years. All included participants were followed up until the date of death or 31 December 2015. PP was categorised into three groups: <50, 50~60, ≥60 mm Hg. Cox proportional hazards models and subgroup analysis were performed to estimate the adjusted HRs and 95% CIs for all-cause mortality.

Results After applying the exclusion criteria, 8356 participants (median age 26.63±7.01 years, 4598 women (55.03%)) were included, of which 265 (3.17%) have died during a median follow-up duration of 152.96±30.45 months. When treating PP as a continuous variable, multivariate Cox analysis showed that PP was an independent risk factor for all-cause mortality (HR 1.94, 95% CI 1.02 to 3.69; p=0.0422). When using PP<50 mm Hg as referent, from the 50~60 mm Hg to the ≥60 mm Hg group, the risks of all-cause mortality for participants with PP ranging 50–60 mm Hg or ≥60 mm Hg were 0.93 (95% CI 0.42 to 2.04) and 1.15 (95% CI 0.32 to 4.07) (P for tend was 0.959). Subgroup analysis showed that PP (HR 2.00, 95% CI 1.05 to 3.82; p=0.0360) was associated with all-cause mortality among non-hypertensive participants.

Conclusion Among young adults, higher PP was significantly associated with an increased risk of all-cause mortality, particularly among those without hypertension.

  • pulse pressure
  • blood pressure
  • mortality
  • young adults
  • NHANES
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Footnotes

  • Contributors JL and YQF designed the study; JL and Y-QH drafted the manuscript; J-YH and KL analysed the data; J-YH and BZ checked the collected data; and KL and J-YH edited and revised the manuscript. The final manuscript was read and approved by all authors.

  • Funding During data analysis and submission of the manuscript, this work was supported by the Science and Technology Program of Guangzhou (grant numbers 201604020143, 201604020018, 201604020186 and 201803040012), the National Key Research and Development Program of China (grant numbers 2017YFC1307603, 2016YFC1301305 and 2017YFC0909303) and the Key Area R&D Program of Guangdong Province (grant number 2019B020227005).

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval The survey protocol was approved by the institutional review board of the Centers for Disease Control and Prevention. All participants gave written informed consent.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open access repository.

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