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To analyze the relationship between longitudinal changes in blood pressure and new-onset cardiovascular diseases (CVD) in older adults with hypertension in the community of Suzhou, and to provide a reference threshold for blood pressure management in older adults.
The physical examination data from 4 019 older adults with hypertension who participated in health check-ups at a community health service center in Suzhou from 2021 to 2023 were collected.Generalized Estimating Equations (GEE) and Restricted Cubic Splines(RCS) models were used to analyze the association between blood pressure changes and new-onset CVD in older adults with hypertension.
A total of 365 new cases of new-onset CVD were observed among older adults, with a cumulative incidence rate of 9.1%. GEE analysis showed that after adjusting for the control variables, diastolic blood pressure (DBP) was negatively associated with the risk of new-onset CVD (OR=0.97, 95% CI: 0.96-0.98, P<0.001), while pulse pressure (PP) was positively associated with the risk of new-onset CVD (OR=1.01, 95% CI: 1.00-1.01, P<0.05). The RCS model showed that there were significant non-linear dose-response relationships between low DBP and the increased risk of new-onset CVD, and between low PP and the decreased risk of new-onset CVD (non-linear test P<0.05). Subgroup analysis showed that DBP≤84 mm Hg and ≥95 mm Hg, and PP between 77 to 88 mm Hg in the uncontrolled systolic blood pressure(SBP) group were significantly associated with an increased risk of new-onset CVD,while PP≤51 mm Hg in the controlled SBP group was significantly associated with a decreased risk of new-onset CVD.
Low and/or high DBP may increase the risk of new-onset CVD in older adults with hypertension in the community, while low PP has a protective effect on new-onset CVD. However, when SBP is not controlled, PP will increase the risk of new-onset CVD in a higher threshold range.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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