Author + information
- Received March 19, 2020
- Accepted April 14, 2020
- Published online June 8, 2020.
- Chi Wang, MDa,∗,
- Yu Yuan, MD, PhDb,∗,
- Mengyi Zheng, MDc,
- An Pan, PhDd,
- Miao Wang, MDa,
- Maoxiang Zhao, MDa,
- Yao Li, MDa,
- Siyu Yao, MDa,
- Shuohua Chen, MDc,
- Shouling Wu, MDc,∗∗ ( and )
- Hao Xue, MDa,∗ ()
- aDepartment of Cardiology, Chinese PLA General Hospital, Beijing, China
- bDepartment of Occupational and Environmental Health, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- cDepartment of Cardiology, Kailuan General Hospital, Tangshan, China
- dDepartment of Epidemiology and Biostatistics, Key Laboratory of Environment and Health, Ministry of Education and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
Background The relations of hypertension onset age with cardiovascular diseases (CVD) and all-cause mortality remain inconclusive.
Objectives This study sought to examine the associations of hypertension onset age with CVD and all-cause mortality.
Methods This prospective study included 71,245 participants free of hypertension and CVD in the first survey (July 2006 to October 2007) of the Kailuan study, a prospective cohort study in Tangshan, China. All participants were followed biennially until December 31, 2017. A total of 20,221 new-onset hypertension cases were identified during follow-up. We randomly selected 1 control participant for each new-onset hypertensive participant, matching for age (±1 year) and sex, and included 19,887 case-control pairs. We used weighted Cox regression models to calculate the average hazard ratios of incident CVD and all-cause mortality across the age groups.
Results During an average follow-up of 6.5 years, we identified 1,672 incident CVD cases and 2,008 deaths. After multivariate adjustment, with the increase in hypertension onset age, the hazards of outcomes were gradually attenuated. The average hazard ratio (95% confidence interval) of CVD and all-cause mortality were 2.26 (1.19 to 4.30) and 2.59 (1.32 to 5.07) for the hypertension onset age <45 years old group, 1.62 (1.24 to 2.12) and 2.12 (1.55 to 2.90) for the 45- to 54-year age group, 1.42 (1.12 to 1.79) and 1.30 (1.03 to 1.62) for the 55- to 64-year age group, and 1.33 (1.04 to 1.69) and 1.29 (1.11 to 1.51) for the ≥65-year age group, respectively (p for interaction = 0.38 for CVD and <0.01 for death).
Conclusions Hypertension was associated with a higher risk for CVD and all-cause mortality, and the associations were stronger with a younger age of onset.
↵∗ Drs. Wang and Yuan contributed equally to this work.
All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.
- Received March 19, 2020.
- Accepted April 14, 2020.
- 2020 American College of Cardiology Foundation
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