Relationship between follow-up systolic blood pressure variability and the risk of all-cause mortality in Chinese elderly:a retrospective cohort study
Objective To investigate the relationship between follow-up systolic blood pressure variability(SBPV)and the risk of all-cause mortality in older adults across China.Methods Based on the follow-up dataset of the 2008-2018 China longitudinal healthy longevity survey(CLHLS),older adults aged 65 years or older with three consecutive times of recorded systolic blood pressure(SBP)and followed up until 2018 were selected as study subjects.A Cox regression analysis model was used to analyze the relationship between follow-up SBPV and all-cause mortality in older adults;analyses were conducted by gender and age subgroups to assess the interaction of follow-up SBPV;and finally,restricted cubic spline(RCS)was added to the model to explore the dose-response relationship between the two.Results(1)A total of 2 582 older adults were enrolled,including 1 253(48.5％)males with a median age of 78(71,86)years.A total of 739(28.6％)older adults died during a mean follow-up period of 3.29 years.(2)After correcting for relevant confounders,there was a significant positive association between follow-up SBPV and the risk of all-cause mortality(P＜0.05).(3)Subgroup analyses showed no effect modification of gender and age on the association between different follow-up SBPV levels and the risk of all-cause mortality(Pinteraction≥0.100).(4)Restricted cubic spline results showed that the dose-response relationship between follow-up SBPV and the risk of all-cause mortality was consistent in both gender,with the risk of all-cause mortality increasing linearly with increasing follow-up SBPV.(Poverall SBPV＜0.001,Pnon-linearity SBPV＞0.05).Among the different age subgroups,follow-up SBPV was positively and linearly associated with the risk of all-cause mortality among those aged＜70 years,while there was no dose-response relationship between the two in the remaining age subgroups(＜70 years old:Poverall SBPV＜0.001,Pnon-linearity SBPV＞0.05;remaining age groups:Poverall SBPV＞0.05,Pnon-linearity SBPV＞0.05).Conclusions Follow-up SBPV was significantly associated with the risk of all-cause mortality in the elderly in China,which was independent of mean follow-up systolic blood pressure.In addition to detecting systolic blood pressure in the elderly population,attention should be paid to fluctuations in systolic blood pressure since the long-term visit.
Systolic blood pressure variabilityRisk of all-cause mortalityDose-response relationship
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