Full
Outline
To investigate the association between systolic blood pressure (SBP) trajectories and the risk of stroke among older adults aged ≥65 years.
Older adults aged ≥65 years from Yangzhong City who participated in at least three rounds of Basic Public Health Service health check-ups between 2016 and 2019 and had no history of cardio-cerebrovascular disease were included.The incidence data of stroke were obtained from the Hospital Information System (HIS) of secondary and above hospitals in Yangzhong City, the Chronic Disease Surveillance Information System of Zhenjiang City, and self-reports from subjects during annual health examinations. Latent class mixed models (LCMM) were used to identify long-term SBP trajectories. Multivariable Cox proportional hazards models were applied to examine the association between different SBP trajectory groups and stroke incidence.
A total of 12 304 older adults were included in the study. LCMM identified two distinct SBP trajectory groups: a low initial SBP with a slight increase group (90.55%) and a high initial SBP with a steep increase group (9.45%). By the end of follow-up on December 31, 2024, totaling 60 266.59 person-years, with an average follow-up time of 4.90 years.2 495 new stroke cases were recorded, with an incidence density of 41.40 per 1 000 person-years. The incidence density was 39.74 per 1 000 person-years in the low initial SBP group and 57.91 per 1 000 person-years in the high initial SBP group. Multivariable Cox proportional hazards analysis showed that compared to the low initial SBP group, the high initial SBP group had a 20% higher risk of stroke (HR=1.20, 95% CI: 1.04-1.38). Stratified analysis showed that the association between SBP trajectory and stroke incidence differed significantly across age groups. In individuals aged over 70 years, the association was stronger (HR=1.26, 95% CI: 1.04-1.51), while in those aged 70 years or younger, the HR was 1.13 (95% CI: 0.91-1.39). The interaction between age and SBP trajectory was statistically significant (P for interaction=0.015).
Among older adults, those with a high initial SBP and a steep increase in SBP over time have a higher risk of stroke. This subgroup should be prioritized in stroke prevention efforts, with strengthened blood pressure monitoring and timely intervention recommended.
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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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