The association of stage 1 hypertension defined by the 2017 ACC/AHA hypertension guideline and subsequent cardiovascular events among adults <50 years.

This study was performed to investigate the association between stage 1 hypertension defined by the 2017 ACC/AHA guidelines and the risk of adverse events among adults aged 35 to 49 years. A total of 20,072 adults aged 35-49 years, without a history of cardiovascular disease (CVD) at baseline were included in the present study. Adjusted Cox proportional hazards models were applied to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). During a median follow-up period of 12.5 years, the results indicated that 777 subjects suffered all-cause death and 299 subjects developed CVD. A total of 830 subjects were involved in incident stroke and 141 subjects had a myocardial infarction (MI). Stage 1 hypertension had a HR (95% CI) of 1.38 (1.13-1.70) for all-cause mortality, 1.74 (1.20-2.53) for CVD mortality, 1.78 for (1.40-2.26) for stroke incidence, and 1.64 (0.99-2.71) for MI incidence, respectively, compared with blood pressure (BP) <120/<80 mmHg. The results show that after adjusting for sex, age, and other potential CVD factors, the incidence of stroke was the only parameter significantly associated with stage 1 hypertension (HR and 95% CI: 1.53, 1.20-1.95). Stage 1 hypertension defined by the 2017 ACC/AHA guidelines was associated with an increased risk of stroke among adults aged 35 to 49 years in rural areas of China.