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Association between pulse pressure and ischaemic stroke in elderly patients with hypertension
  1. Jiayi Huang1,
  2. Lin Liu1,
  3. Yu-Qing Huang1,
  4. Kenneth Lo2,
  5. Yu-Ling Yu1,
  6. Chao-Lei Chen1,
  7. Song-tao Tang3,
  8. Bin Zhang1,
  9. Ying Qing Feng1
  1. 1Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Academy of Medical Sciences, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
  2. 2Department of Epidemiology, Centre for Global Cardiometabolic Health, School of Public Health, Brown University, Providence, Rhode Island, USA
  3. 3Community Health Center of Liaobu County, Dongguan, China
  1. Correspondence to Professor Ying Qing Feng, Department of Cardiology, Guangdong Provincial People’s Hospital, Guangdong Cardiovascular Institute, Hypertension Research Laboratory, Guangdong Academy of Medical Sciences, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China, Guangzhou 510080, China; 651792209{at}qq.com; Dr Song-tao Tang, Community Health Center of Liaobu County, Dongguan, China; 3038384760{at}qq.com

Abstract

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.

  • hypertension
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Footnotes

  • 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.

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