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It is unclear whether there are different body mass index (BMI) trajectories among a population with normal BMI levels, and the association between BMI patterns and incident hypertension is not well characterized. This prospective cohort study includes surveys conducted at baseline and three follow-ups. 3939 participants who are free of hypertension at baseline or first two follow-ups were enrolled. At baseline, the age of participants ranged from 35 to 82 years and the mean age was 45.9 years. The BMI trajectories were identified using latent mixture modeling with data from the baseline and first two follow-ups. The effects of different BMI trajectories on the development of hypertension were analyzed using a Cox proportional hazard model. Four distinct BMI trajectories were identified over the study period (2004-2010): normal-stable (n = 1456), normal-increasing (n = 2159), normal-fluctuated (n = 166), and normal-sharp-increasing (n = 158). Relative to the normal-stable BMI group, the hazard ratios (HRs) and 95% confidence intervals (CIs) after adjustment for confounding factors of the normal-increasing, normal-fluctuated, and normal-sharp-increasing groups were 1.244 (1.103-1.402), 1.331 (1.008-1.756), and 1.641 (1.257-2.142), respectively. Additionally, subgroup analysis showed that the normal-fluctuated BMI trajectory was associated with a significantly higher risk of hypertension only in women (HR = 1.362; 95% CI = 1.151-1.611). The BMI trajectories were significant predictors of hypertension incidence, and increasing BMI trajectories within the currently designated normal range were associated with an increased hypertension risk, especially in women. [ABSTRACT FROM AUTHOR]

This study aimed to assess the impact of the 2017 American College of Cardiology and American Heart Association (ACC/AHA) guideline and the 2018 Chinese hypertension guidelines on the different secular trends for hypertension prevalence. A total of 82 665 eligible individuals aged ≥20 years were selected from nine cross‐sectional study periods (1991‐2015) from the China Health and Nutrition Survey (CHNS). Over the 24‐year period, the long‐term trend for the prevalence of the 2017 ACC/AHA‐defined age‐adjusted hypertension showed an increase from 32.2% (95% confidence interval (CI): 31.0%‐33.3%) in 1991 to 60.0% (95% CI: 58.6%‐61.3%) in 2015 (Ptrend < 0.001). According to the 2018 Chinese guideline for hypertension, the weighted hypertension prevalence increased from 10.0% (95% CI: 9.4%‐10.5%) in 1991 to 28.7% (95% CI: 27.9%‐29.6%) in 2015 (Ptrend < 0.001). However, slopes of increasing prevalence of hypertension were significantly greater according to the 2017 ACC/AHA guideline than that based on Joint National Committee (JNC 7) report (β = 1.00% vs β = 0.67% per year, respectively, P = 0.041). Based on the 2017 ACC/AHA definition, the prevalence of stage 1 hypertension and elevated blood pressure significantly increase from 22.3% and 6.9% in 1991 to 31.2% and 10.1% in 2015 (all P < 0.05), respectively. The secular trend for the prevalence of hypertension according to the 2017 ACC/AHA guideline showed a greater rate of increase compared with the prevalence based on the 2018 Chinese hypertension guidelines. Public health initiatives should focus on the current status of hypertension in China because of the possible high prevalence of hypertension and concomitant vascular risks. [ABSTRACT FROM AUTHOR]

The 2017 American College of Cardiology and American Heart Association (ACC/AHA) hypertension guideline updated stage 1 hypertension defined as systolic blood pressure (SBP) of 130-139 mm Hg or diastolic blood pressure (DBP) of 80-89 mm Hg. However, the impact of 1 hypertension that affects future cardiovascular risk remains unclear among older adults in rural China. The prospective cohort study included 7503 adults aged ≥60 years with complete data and no cardiovascular disease (CVD) at baseline. Follow-up for the new adverse events was conducted from the end of the baseline survey to the end of the third follow-up survey (2007.01-2017.12). Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for blood pressure (BP) classifications and adverse events with normal BP as reference (< 120/80 mm Hg). During the 57 290 person-years follow-up period, 2261 all-cause mortality, 1271 CVD mortality, 1159 stroke, and 347 myocardial infarctions (MI) occurred. Patients with stage 1 hypertension versus normal BP had HRs (95% CI) of 1.068 (0.904-1.261) for all-cause mortality, 1.304 (1.015-1.675) for CVD mortality, 1.449 (1.107-1.899) for stroke, and 1.735 (1.051-2.863) for MI, respectively. In conclusion, among adults aged ≥60 years, stage 1 hypertension revealed an increased hazard of CVD mortality, stroke, and MI, which is complementary evidence for the application of 2017 ACC/AHA hypertension guidelines in an older Chinese population. Therefore, BP control in patients with stage 1 hypertension may be beneficial to reduce the hazard of CVD in elderly Chinese individuals. [ABSTRACT FROM AUTHOR]