Association between systolic blood pressure and first ischemic stroke in the Chinese older hypertensive population

Objective This study aimed to evaluate the association between systolic blood pressure (SBP) and first ischemic stroke in older people with hypertension in the community. Methods This retrospective cohort study included 3315 residents who were hypertensive and older than 60 years in Guangdong, China. Results A total of 1475 men and 1840 women aged 71.41 +/- 7.20 years were included. All subjects had a median follow-up duration for 5.5 years and 206 subjects reached the endpoint. The prevalence of first ischemic stroke increased with a higher SBP. SBP expressed as a continuous variable (hazard ratio [HR], 1.01; 95% confidence interval [CI], 1.00-1.02) and categorical variable (HRs, 1.00, 1.06, 1.17, 1.39, and 1.60 for increasing blood pressure from < 120->= 150 mmHg), was significantly associated with a higher risk of first ischemic stroke. Moreover, a fully adjusted model indicated an obvious increased risk in the SBP >= 150 mmHg group (HR, 1.60; 95% CI, 1.15-2.71) and the SBP 140-149 mmHg group (HR, 1.39; 95% CI, 1.01-2.39). Conclusions High SBP was independently associated with the risk of first ischemic stroke in hypertensive residents in the community aged older than 60 years. SBP >= 140 mmHg increases the risk of first ischemic stroke.