Relationship between blood pressure and the risk of acute myocardial infarction in Chinese adults: a prospective study

Objective To explore the relationship between blood pressure and the risk of acute myocardial infarction (AMI) in Chinese adults. Methods This prospective cohort study included 26,794 participants which were recruited from 60 surveillance sites in 2010 China Chronic Disease Risk Factor Surveillance and followed-up survey was conducted from 2016 to 2017. Data were collected by questionnaires, physical measurements and laboratory tests. Blood pressure was grouped by systolic blood pressure and diastolic blood pressure, and cox proportional hazards regression models were used to analyze the relationship between blood pressure and risk of AMI. Results A total of 256 AMI events occurred among 160,386.38 person-years follow-up and the incidence of AMI was 159.6/100,000 person-years. After adjusting for age, sex, income, education, marital status, physical activity, drinking, abdominal obesity, BMI, dyslipidemia and diabetes, compared with normotension group, the risk of AMI onset was increased by 61% ( HR =1.61, 95% CI 1.17∼2.21), 60% ( HR =1.60, 95% CI 1.17∼2.20), 84% ( HR =1.84, 95% CI 1.26∼2.68) and 120% ( HR= 2.20, 95% CI 1.43∼3.38) in systolic diastolic hypertension(SDH), hypertension grade 1(mild), hypertension grade 2(moderate), hypertension grade 3(severe), respectively. In addition, after adjusting for relevant factors, the relationship between hypertension and the risk of AMI may be influenced by abdominal obesity, diabetes and lack of physical activity. Conclusions The incidence of AMI appears to be considerable among Chinese adults and hypertension is an independent risk factor for its onset. The risk of AMI is higher in participants with more severe hypertension.