Association between blood pressure indicators and stroke in aged population: A community-based nested case-control study

Abstract

Background and Aim: Any single discrete blood pressure (BP) measurement is not enough to estimate adverse cardiovascular events. We aim to comprehensively investigate the association between BP indicators and stroke. Methods: An observational cohort study was conducted among 2888 Shanghai community-aged residents from 2014 to 2018, and a nested case-control study was designed to identify the association between BP indicators and stroke. In total 415 cases of stroke detected during the study period were selected as the case group and 415 non-stroke subjects, matched with factors of age and gender, were randomly selected from the cohort as control group. Results: Multivariate logistic regression analysis revealed that systolic blood pressure (SBP) (adjusted odds ratio [AOR] 1.02, 95% confidence interval [CI] 1.02–1.03), pulse pressure (PP) (AOR 1.03, 95% CI 1.02–1.04), mean arterial pressure (MAP) (AOR1.02, 95% CI 1.01–1.04) and pulse pressure index (PPI) (AOR 25.68, 95% CI 3.19–206.90) increased the risk of stroke, respectively. After fitting both BP indicators and covariates, isolated abnormal SBP (AOR 2.55, 95% CI 1.74–3.72) or PP ≥50 mmHg (AOR 1.66, 95% CI 1.08–2.56) independently increased risk of stroke. Conclusion: Besides SBP, PP and multiple factors, assessment should be taken into account comprehensively for stroke prevention and management.