The Associations Between Blood Pressure Parameters and Stroke in Chinese Rural Population: The Henan Rural Cohort Study

Aim: This study aimed to verify the associations of blood pressure (BP) parameters with the risk of stroke in Chinese rural population. Simultaneously, we quantified how much of the effects of BP on stroke were mediated through metabolic factors. Methods: A total of 38880 subjects aged 18 to 79 were derived from the Henan Rural Cohort study. Restricted cubic splines and logistic regression were used to estimate the OR s and 95% CI s. We used factor analysis to create continuous variables of metabolic dysfunctions to be examined as potential mediator of the association between BP and stroke. Mediation analysis using bootstrap was performed to examine the contribution of metabolic factors to BP parameters related stroke. Results: After adjusting for potential confounders, the OR s (95% CI s) of SBP, DBP, PP and MAP in the highest quartile with the risk of stroke were 1.96 (1.70-2.27), 1.80 1.58-2.05), 1.66 (1.42-1.94), 1.95 (1.70-2.24). The restricted cubic splines showed that the risk of stroke increased gradually with continuous BP levels. We further reported that 11.45%-20.98% of excess relative risk of stroke was mediated through metabolic factors for BP parameters. Conclusion: Elevated BP were significantly associated with the risk of stroke especially in SBP and MAP. In addition, metabolic factors explained part of the associations. Figure 3 Mediation analysis to determine the relationship between SBP (A), DBP (B), PP (C), MAP (D) and stroke through metabolic factors. M, metabolic factors.OR(95% CI)of total effect for SBP, DBP, PP and MAP on total stroke was 1.0122 (1.0102-1.0142), 1.0205 (1.0169-1.0240), 1.0131 (1.0099-1.0163) and 1.0185 (1.0155-1.0214), respectively.