Association Of The Number Of Times Blood Pressure Achieve Target With The Risk Of Incident Cardiovascular And Cerebrovascular Diseases Among Patients With Hypertension

Objectives Cardiovascular and cerebrovascular diseases(CCVD)which included stroke(ischemic stroke and hemorrhagic stroke)and acute myocardial infarction are the common clinical disease.There is no relevant research on the impact of the number of reaching target blood pressure on the incidence of CCVD although the risk of developing CCVD in patients with hypertension can be reduced due to early achievement of target blood pressure.Therefore,our study was to investigate the association between the times of reaching target blood pressure and the incidence of cardiovascular and cerebrovascular diseases in patients with hypertension.Methods A prospective cohort study was conducted.We reviewed the records of employees diagnosed with hypertension in physical examination of Kailuan Group in 2006,who also participated in the physical examination in 2008,2010 and 2012 with complete blood pressure data were enrolled in this study.Patients with a history of CCVD and malignant disease were excluded from the study.The participants were divided into 0 time,1 time,2 times and 3 times groups based on the times of reaching target blood pressure in the physical examination in 2008,2010 and 2012.The incidence of new CCVD in each group was observed,and the cumulative incidence was calculated by Kaplan-Meier method and tested by log-rank method.Multivariate Cox regression model was used to analyze the effect of the times of reaching target blood pressure on the incidence of new-onset CCVD and its subtypes of stroke(ischemic stroke,hemorrhagic stroke)and acute myocardial infarction in hypertensive patients.Results The mean age of participants was(57.75±10.86)years.The mean follow-up of participants was(6.84±0.89)years.The cumulative incidence of new-onset CCVD in 0time,1 time,2 times and 3 times groups was 9.47%,7.52%,5.20%,3.24%,respectively(χ~2=125.04,P<0.01).The multifactorial Cox regression model showed that the risk of new-onset CCVD was lower in the 2 times group(HR:0.65,95%CI:0.53-0.78)and 3 times group(HR:0.43,95%CI:0.33-0.57)compared with the 0 times group,whereas there was no significant difference in 1 time group(HR:0.89,95%CI:0.77-1.03).Further analysis showed that the results of revealed stroke and its subtype ischemic stroke were consistent with the above results.Conclusions The times of reaching target blood pressure in hypertensive patients is a protective factor for new-onset CCVD.Continuous blood pressure up to standard can reduce the risk of new-onset CCVD.Figure 5;Table 8;Reference 141...