Relationship between hypertension and cardiovascular and cerebrovascular diseases among adult residents in Hainan Province: A prospective cohort study

WANG Xiao-huan1 HU Xi-min1 GUO Yu2 BIAN Zheng LI Li-ming3 CHEN Zheng-ming4 LI Hui-mei5 LI Yi-Lei FU Zhi-fang

(1.Institute of Tropical and Chronic Diseases, Hainan Provincial Center for Disease Control and Prevention, Haikou, Hainan Province, China 570203)
(2.Chinese Academy of Medical Sciences)
(3.School of Public Health, Peking University)
(4.Clinical Trial Service Unit & Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford)
(5.Center for Disease Control and Prevention, Meilan District, Haikou City)

【Abstract】 Objective To explore the relationship of hypertension with cardiovascular and cerebrovascular diseases among adult residents in Hainan Province and to provide references for the prevention and control of cardiovascular and cerebrovascular diseases. Methods We conducted a prospective cohort study among 30 000 residents aged 30–79 years selected with cluster sampling in Meilan District of Hainan Province. The baseline survey for the study was performed from June 2005 to July 2008 and then a long-term follow-up was conducted among the residents. Univariate and multivariate Cox regressions were used to analyze the association of hypertension with cardiovascular and cerebrovascular diseases among the residents. Results Among all the residents, 309 deaths were observed and only 3 (0.01%) were lost to follow-up till December 31, 2013; and the follow-up time ranged from 0 to 9 years and the mean time was 6.7 ± 1.4 years, with a total of 175 667 person years of follow-up. By the end of the follow-up, the incidents and accumulated incidence rate were 2 824 and 10.8% for cardiovascular diseases, 669 and 2.6% for ischemic heart disease, 2 059 and 7.8% for cerebrovascular diseases, 91 and 0.4% for haemorrhagic stroke, and 1 716 and 6.5% for ischaemic stroke, respectively. Multivariate Cox regression analysis indicated that compared with the residents with normal blood pressure, the residents with hypertension had significantly increased risks of cardiovascular and cerebrovascular diseases after adjusting for gender, age, education, marital status, smoking, alcohol drinking, diabetes, familial cardiovascular and cerebrovascular disease history, body mass index (BMI), and other confounding factors, with the hazard ratios (HRs) (95% confidence interval [95% CI]) of 2.76 (1.77–4.29) for haemorrhagic stroke, 1.25 (1.06–1.49) for ischemic heart disease, 1.19 (1.10–1.30) for cardiovascular disease, 1.15 (1.04–1.27) for cerebrovascular disease, and 1.11 (1.00–1.23) for ischemic stroke, respectively. The residents with isolated systolic hypertension had significantly increased risks of haemorrhagic stroke (HR = 1.79, 95% CI: 1.07–3.00), ischemic heart disease (1.23, 1.01–1.50), and cardiovascular disease (1.15, 1.04–1.27). The residents with systolic-diastolic hypertension had significantly increased risks of haemorrhagic stroke (HR = 3.84, 95% CI: 2.14–6.88), ischemic heart disease (1.45, 1.10–1.91), cardiovascular disease (1.32, 1.14–1.51), ischaemic stroke (1.30, 1.09–1.54), and cerebrovascular disease (1.29, 1.10–1.52). Conclusion Hypertension, especially systolic-diastolic hypertension, increases the risks of cardiovascular and cerebrovascular diseases among adult community residents in Hainan Province.

【Keywords】 hypertension; cardiovascular and cerebrovascular diseases; incidence; relationship; prospective cohort study;

【Funds】 National Key Research and Development Program of China (2016YFC0900500) Wellcome Trust of the United Kingdom (088158/Z/09/Z)

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(Translated by ZHAO B)


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This Article


CN: 21-1234/R

Vol 35, No. 08, Pages 986-991

August 2019


Article Outline


  • 1 Subjects and methods
  • 2 Results
  • 3 Discussion
  • References