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.