Age-specific in the relationship between diastolic blood pressure and the risk of cardiovascular disease: A cohort study of the UK Biobank

Aims

To investigate the effect of optimal diastolic blood pressure (DBP) level on cardiovascular disease (CVD) events, considering different age groups. And the nonlinear relationship between DBP and CVD events by age were evaluated.

Methods

358,734 participants of the UK biobank were included. Multivariable Cox regressions were performed to evaluate the relation between DBP and cardiovascular risk, and the natural cubic spline was applied to estimate the nonlinear relationship between the DBP measures and the hazard.

Results

In the UK Biobank, a total of 358,734 participants (mean [SD] age, 55.3 [8.1] years; 205,215 [57.2 %] female) were included in this analysis. The rate of CVD cases was 6.05 per 1000 person-years. For each SD increase, DBP was associated with elevated CVD events for both <50 year (HR, 1.19; 95 % CI, 1.12 to 1.26) and 50–59 year-old group (HR, 1.04; 95 % CI, 1.01 to 1.08). However, for every SD increment, a marginal protective effect against CVD events was observed between DBP and the CVD events in elder people (≥60 years old) and lower DBP (<70 mm Hg) may confer an increased CVD risks (HR, 1.10; 95 % CI, 1.03 to 1.17).

Conclusions

For adults younger than 60 years old, the study seems to support the ACC/AHA blood pressure guidelines lowering the DBP threshold to 80 mm Hg. Conversely, it may be reasonable to rule out large effects of high DBP on CVD events and DBP <70 mm Hg may be cause for caution in older people aged 60–69.