Deaths from total and premature cardiovascular disease associated with high normal blood pressure and hypertension in rural Chinese men and elderly people

To investigate the association of blood pressure (BP) categories with total and premature cardiovascular disease (CVD) mortality in rural Chinese. The study included 14,539 adults ≥18 years in rural China. Baseline study visits were conducted in 2007–2008, and follow-up visits in 2013–2014. Data were collected by face-to-face questionnaire interview, and anthropometric and laboratory measurements. A sub-distribution hazards model was used to calculate adjusted sub-distribution hazard ratios (aSHRs) and 95% confidence intervals (CIs). During the 6-year follow-up, 257 total and 209 premature CVD deaths occurred. As compared with normal BP (systolic BP/diastolic BP (SBP/DBP) < 120/80 mmHg), for men and people aged ≥60 years, hypertension (SBP/DBP ≥ 140/90 mmHg) associated with total CVD mortality (aSHR 3.57, 95% CI 2.06–6.17; aSHR 2.15, 1.29–3.56) and premature CVD mortality (aSHR 4.41, 2.37–8.21; aSHR 2.31, 1.27–4.19). Also, as compared with normal BP, for men and people aged ≥60 years with high normal BP (SBP/DBP 120–139/80–89 mmHg), risk of total CVD mortality increased (aSHR 1.85, 1.05–3.28; aSHR 1.78, 1.05–3.04), as was premature CVD mortality (aSHR 1.89, 0.99–3.64; aSHR 1.91, 1.03–3.54). Among men and people aged ≥60 years in rural China, risk of total and premature CVD mortality was increased for those with high normal BP and hypertension. Prevention and treatment strategies for additional CVD risk reduction targeting men and elderly people with hypertension or even high normal BP are needed to reduce CVD mortality risk.