Introduction
Participants and methods
Study design
Participants
Variables
Follow-up procedure
Statistical analysis
Results
Baseline characteristics of selected participants
Blood pressure tertiles (mmHg) | SBP | DBP | ||||||
---|---|---|---|---|---|---|---|---|
Low 84–118 | Middle 119–133 | High 134–168 | P value* | Low 53–70 | Middle 71–79 | High 80–105 | P value* | |
N | 171 | 171 | 172 | 171 | 170 | 173 | ||
Age | 61.82 ± 10.34 | 60.44 ± 9.66 | 63.50 ± 8.16 | 0.022 | 64.14 ± 10.05 | 61.26 ± 9.50 | 60.39 ± 8.52 | < 0.001 |
Sex | 0.002 | 0.852 | ||||||
Male | 126 (73.68%) | 121 (70.76%) | 98 (56.98%) | 112 (65.50%) | 116 (68.24%) | 117 (67.63%) | ||
Female | 45 (26.32%) | 50 (29.24%) | 74 (43.02%) | 59 (34.50%) | 54 (31.76%) | 56 (32.37%) | ||
Alcohol consumption | 0.350 | 0.221 | ||||||
Nondrinker | 105 (61.40%) | 100 (58.48%) | 113 (65.70%) | 116 (67.84%) | 104 (61.18%) | 98 (56.65%) | ||
Current drinker | 51 (29.82%) | 62 (36.26%) | 48 (27.91%) | 45 (26.32%) | 52 (30.59%) | 64 (36.99%) | ||
Quit | 15 (8.77%) | 9 (5.26%) | 11 (6.40%) | 10 (5.85%) | 14 (8.24%) | 11 (6.36%) | ||
Smoke or not | 0.288 | 0.718 | ||||||
Nonsmoker | 82 (47.95%) | 83 (48.54%) | 97 (56.40%) | 88 (51.46%) | 83 (48.82%) | 91 (52.60%) | ||
Current smoker | 53 (30.99%) | 61 (35.67%) | 48 (27.91%) | 53 (30.99%) | 60 (35.29%) | 49 (28.32%) | ||
Quit | 36 (21.05%) | 27 (15.79%) | 27 (15.70%) | 30 (17.54%) | 27 (15.88%) | 33 (19.08%) | ||
Degree of education | 0.032 | 0.697 | ||||||
Illiterate | 29 (16.96%) | 38 (22.22%) | 52 (30.23%) | 43 (25.15%) | 37 (21.76%) | 39 (22.54%) | ||
Primary school | 45 (26.32%) | 34 (19.88%) | 45 (26.16%) | 46 (26.90%) | 40 (23.53%) | 38 (21.97%) | ||
Junior school | 52 (30.41%) | 56 (32.75%) | 36 (20.93%) | 48 (28.07%) | 48 (28.24%) | 48 (27.75%) | ||
High school and above | 45 (26.32%) | 43 (25.15%) | 39 (22.67%) | 34 (19.88%) | 45 (26.47%) | 48 (27.75%) | ||
AF | 0.659 | 0.470 | ||||||
No | 165 (96.49%) | 167 (97.66%) | 165 (95.93%) | 167 (97.66%) | 165 (97.06%) | 165 (95.38%) | ||
Yes | 6 (3.51%) | 4 (2.34%) | 7 (4.07%) | 4 (2.34%) | 5 (2.94%) | 8 (4.62%) | ||
DM | 0.876 | 0.766 | ||||||
No | 125 (73.10%) | 121 (70.76%) | 125 (72.67%) | 120 (70.18%) | 125 (73.53%) | 126 (72.83%) | ||
Yes | 46 (26.90%) | 50 (29.24%) | 47 (27.33%) | 51 (29.82%) | 45 (26.47%) | 47 (27.17%) | ||
Heart failure history | 0.239 | 0.332 | ||||||
No | 166 (97.08%) | 170 (99.42%) | 170 (98.84%) | 168 (98.25%) | 166 (97.65%) | 172 (99.42%) | ||
Yes | 5 (2.92%) | 1 (0.58%) | 2 (1.16%) | 3 (1.75%) | 4 (2.35%) | 1 (0.58%) | ||
Unstable angina | < 0.001 | < 0.001 | ||||||
No | 108 (63.16%) | 65 (38.01%) | 35 (20.35%) | 94 (54.97%) | 60 (35.29%) | 54 (31.21%) | ||
Yes | 63 (36.84%) | 106 (61.99%) | 137 (79.65%) | 77 (45.03%) | 110 (64.71%) | 119 (68.79%) | ||
Myocardial infarction | < 0.001 | < 0.001 | ||||||
No | 63 (36.84%) | 106 (61.99%) | 137 (79.65%) | 77 (45.03%) | 110 (64.71%) | 119 (68.79%) | ||
Yes | 108 (63.16%) | 65 (38.01%) | 35 (20.35%) | 94 (54.97%) | 60 (35.29%) | 54 (31.21%) | ||
Myocardial bridge | 0.398 | 0.124 | ||||||
No | 161 (94.15%) | 163 (95.32%) | 157 (91.28%) | 159 (92.98%) | 155 (91.18%) | 167 (96.53%) | ||
Yes | 10 (5.85%) | 8 (4.68%) | 15 (8.72%) | 12 (7.02%) | 15 (8.82%) | 6 (3.47%) | ||
Cerebral infarction | 0.002 | 0.065 | ||||||
No | 153 (89.47%) | 149 (87.13%) | 132 (76.74%) | 152 (88.89%) | 144 (84.71%) | 138 (79.77%) | ||
Yes | 18 (10.53%) | 22 (12.87%) | 40 (23.26%) | 19 (11.11%) | 26 (15.29%) | 35 (20.23%) | ||
Number of stent | 0.394 | 0.139 | ||||||
1 | 133 (77.77%) | 123 (71.93%) | 113 (65.69%) | 136 (79.53%) | 115 (67.65%) | 118 (68.21%) | ||
2 | 26 (15.20%) | 36 (21.05%) | 45 (26.16%) | 26 (15.20%) | 44 (25.88%) | 37 (21.39%) | ||
3 | 11 (6.43%) | 10 (5.85%) | 11 (6.40%) | 8 (4.68%) | 9 (5.29%) | 15 (8.67%) | ||
4 | 1 (0.58%) | 2 (1.17%) | 3 (1.74%) | 1 (0.58%) | 2 (1.17%) | 3 (1.73%) | ||
BMI | 24.76 ± 3.53 | 25.83 ± 3.62 | 26.40 ± 3.68 | < 0.001 | 24.72 ± 3.64 | 25.85 ± 3.31 | 26.41 ± 3.84 | < 0.001 |
Cl− | 102.33 ± 3.08 | 102.07 ± 3.17 | 102.72 ± 2.89 | 0.253 | 102.18 ± 3.08 | 102.42 ± 2.35 | 102.51 ± 3.58 | 0.496 |
Creatinine | 67.42 ± 16.23 | 68.68 ± 24.28 | 69.93 ± 38.07 | 0.878 | 67.75 ± 17.27 | 68.50 ± 34.55 | 69.90 ± 29.47 | 0.788 |
Cysteine protease inhibitor C | 1.05 ± 0.27 | 1.06 ± 0.30 | 1.15 ± 0.40 | 0.012 | 1.09 ± 0.27 | 1.09 ± 0.36 | 1.08 ± 0.37 | 0.563 |
FT3 Free triiodothyrotropin | 4.61 ± 1.68 | 4.58 ± 0.78 | 4.93 ± 3.73 | 0.391 | 4.40 ± 0.96 | 5.05 ± 3.89 | 4.67 ± 1.27 | 0.039 |
FT4 | 16.50 ± 4.44 | 15.88 ± 2.17 | 16.46 ± 4.80 | 0.710 | 15.87 ± 2.62 | 16.56 ± 4.77 | 16.31 ± 3.97 | 0.940 |
TSH | 2.11 ± 1.73 | 2.64 ± 1.82 | 3.71 ± 8.84 | 0.003 | 2.35 ± 2.02 | 2.34 ± 1.49 | 3.80 ± 8.74 | 0.016 |
HDL-C | 1.08 ± 0.30 | 1.09 ± 0.27 | 1.07 ± 0.25 | 0.561 | 1.10 ± 0.30 | 1.07 ± 0.27 | 1.08 ± 0.24 | 0.925 |
LDL-C | 2.42 ± 0.77 | 2.52 ± 0.85 | 2.53 ± 0.86 | 0.538 | 2.57 ± 0.92 | 2.48 ± 0.77 | 2.42 ± 0.80 | 0.612 |
Lipoprotein | 182.00 (92.00–325.00) | 169.50 (95.00–349.50) | 190.50 (96.50–344.25) | 0.848 | 218.00 (98.50–412.50) | 157.00 (91.75–320.00) | 165.00 (94.00–308.25) | 0.120 |
K+ | 4.15 ± 0.42 | 4.22 ± 0.38 | 4.15 ± 0.44 | 0.226 | 4.18 ± 0.43 | 4.19 ± 0.43 | 4.16 ± 0.39 | 0.801 |
LVEF | 55.66 ± 7.44 | 57.54 ± 5.35 | 57.90 ± 4.17 | 0.165 | 56.55 ± 6.56 | 57.24 ± 5.72 | 57.56 ± 4.91 | 0.632 |
Na+ | 140.83 ± 2.84 | 141.23 ± 2.84 | 141.81 ± 2.39 | 0.017 | 140.98 ± 2.84 | 141.49 ± 2.55 | 141.44 ± 2.74 | 0.143 |
TC | 4.12 ± 1.08 | 4.29 ± 1.10 | 4.40 ± 1.14 | 0.091 | 4.34 ± 1.25 | 4.27 ± 1.03 | 4.21 ± 1.05 | 0.942 |
TG | 1.50 ± 0.91 | 1.53 ± 1.00 | 1.72 ± 1.12 | 0.141 | 1.52 ± 1.05 | 1.60 ± 1.04 | 1.63 ± 0.96 | 0.350 |
UA | 288.93 ± 90.22 | 308.09 ± 71.10 | 298.71 ± 78.67 | 0.112 | 294.57 ± 90.00 | 291.34 ± 74.43 | 310.63 ± 74.28 | 0.036 |
Urea | 5.28 ± 1.78 | 5.40 ± 1.64 | 5.55 ± 2.03 | 0.317 | 5.48 ± 1.80 | 5.42 ± 2.05 | 5.34 ± 1.60 | 0.814 |
ACEI | 0.178 | 0.584 | ||||||
No | 109 (63.74%) | 110 (64.33%) | 124 (72.09%) | 110 (64.33%) | 118 (69.41%) | 115 (66.47%) | ||
Yes | 62 (36.26%) | 61 (35.67%) | 48 (27.91%) | 61 (35.67%) | 52 (30.59%) | 58 (33.53%) | ||
ARB | < 0.001 | < 0.001 | ||||||
No | 159 (92.98%) | 143(83.63%) | 120 (69.77%) | 159 (92.98%) | 135 (79.41%) | 128 (73.99%) | ||
Yes | 12 (7.02%) | 28 (16.37%) | 52 (30.23%) | 12 (7.02%) | 35 (20.59%) | 45 (26.01%) | ||
Aspirin | 0.643 | 0.549 | ||||||
No | 4(2.34%) | 1 (0.58%) | 3 (1.74%) | 4 (2.34%) | 3 (1.76%) | 1 (0.58%) | ||
Yes | 167 (97.66%) | 170 (99.42%) | 169 (98.26%) | 167 (97.66%) | 167 (98.24%) | 172 (99.42%) | ||
b-blocker | 0.019 | 0.921 | ||||||
No | 24 (14.04%) | 37 (21.64%) | 44 (25.58%) | 37 (21.64%) | 33 (19.41%) | 35 (20.23%) | ||
Yes | 147 (85.96%) | 134 (78.36%) | 128 (74.42%) | 134 (78.36%) | 137 (80.59%) | 138 (79.77%) | ||
Clopidogrel | 0.043 | 0.321 | ||||||
No | 83 (48.54%) | 70 (40.94%) | 60 (34.88%) | 79 (46.20%) | 65 (38.24%) | 69 (39.88%) | ||
Yes | 88 (51.46%) | 101 (59.06%) | 112 (65.12%) | 92 (53.80%) | 105 (61.76%) | 104 (60.12%) | ||
Nitrates | 0.587 | 0.265 | ||||||
No | 71 (41.52%) | 75 (43.86%) | 66 (38.37%) | 70 (40.94%) | 63 (37.06%) | 79 (45.66%) | ||
Yes | 100 (58.48%) | 96 (56.14%) | 106 (61.63%) | 101 (59.06%) | 107 (62.94%) | 94 (54.34%) | ||
Stain | 0.007 | 0.035 | ||||||
No | 10 (5.85%) | 2 (1.17%) | 1 (0.58%) | 9 (5.26%) | 1 (0.59%) | 3 (1.73%) | ||
Yes | 161 (94.15%) | 169 (98.83%) | 171 (99.42%) | 162 (94.74%) | 169 (99.41%) | 170 (98.27%) | ||
Ticagrelor | 0.029 | 0.363 | ||||||
No | 95 (55.56%) | 107 (62.57%) | 119 (69.19%) | 100 (58.48%) | 109 (64.12%) | 112 (64.74%) | ||
Yes | 76 (44.44%) | 64 (37.43%) | 53 (30.81%) | 71 (41.52%) | 61 (35.88%) | 61 (35.26%) | ||
MACE | 0.577 | 0.574 | ||||||
No | 144 (84.21%) | 137 (80.12%) | 139 (80.81%) | 142 (83.04%) | 141 (82.94%) | 137 (79.19%) | ||
Yes | 27 (15.79%) | 34 (19.88%) | 33 (19.19%) | 29 (16.96%) | 29 (17.06%) | 36 (20.81%) |
Result of univariate analysis
Covariate | Statistics | β (95%CI) | P value |
---|---|---|---|
Age | 61.92 ± 9.49 | 1.03 (1.01, 1.05) | 0.045 |
Sex | |||
Male | 345 (67.12%) | Reference | |
Female | 169 (32.88%) | 0.88 (0.54, 1.45) | 0.625 |
Alcohol consumption | |||
Nondrinker | 318 (61.87%) | Reference | |
Current drinker | 161 (31.32%) | 0.94 (0.53, 1.66) | 0.832 |
Quit | 35 (6.81%) | 0.54 (0.17, 1.66) | 0.281 |
Smoke or not | |||
Nonsmoker | 262 (50.97%) | Reference | |
Current smoker | 162 (31.52%) | 1.08 (0.58, 2.02) | 0.801 |
Quit | 90 (17.51%) | 1.00 (0.48, 2.06) | 0.996 |
Degree of education | |||
Illiterate | 119 (23.15%) | Reference | |
Primary school | 124 (24.12%) | 1.69 (0.85, 3.35) | 0.136 |
Junior school | 144 (28.02%) | 1.07 (0.50, 2.29) | 0.868 |
High school and above | 127 (24.71%) | 1.54 (0.72, 3.27) | 0.262 |
AF | |||
No | 497 (96.69%) | Reference | |
Yes | 17 (3.31%) | 0.48 (0.10, 2.21) | 0.346 |
DM | |||
No | 371 (72.18%) | Reference | |
Yes | 143 (27.82%) | 2.01 (1.82, 2.20) | 0.024 |
Heart failure history | |||
No | 506 (98.44%) | Reference | |
Yes | 8 (1.56%) | 0.64 (0.08, 5.32) | 0.675 |
Unstable angina | |||
No | 208 (40.47%) | Reference | |
Yes | 306 (59.53%) | 1.24(0.78,1.98) | 0.359 |
Myocardial infarction | |||
No | 306 (59.53%) | Reference | |
Yes | 208 (40.47%) | 0.90 (0.56, 1.46) | 0.677 |
Myocardial bridge | |||
No | 481 (93.58%) | Reference | |
Yes | 33 (6.42%) | 0.84 (0.31, 2.25) | 0.722 |
Cerebral infarction | |||
No | 434 (84.44%) | Reference | |
Yes | 80 (15.56%) | 1.85 (1.62, 2.08) | 0.038 |
Number of stent | |||
1 | 369 (71.90%) | Reference | |
2 | 107 (20.82%) | 0.82 (0.46, 1.46) | 0.499 |
3 | 32 (6.23%) | 1.44 (0.62, 3.34) | 0.401 |
4 | 6 (1.17%) | 0.78 (0.09, 6.79) | 0.819 |
BMI | 25.67 ± 3.66 | 1.03 (0.97, 1.10) | 0.384 |
Cl− | 102.38 ± 3.05 | 1.00 (0.92, 1.08) | 0.957 |
Creatinine | 68.73 ± 28.04 | 1.00 (0.99, 1.01) | 0.528 |
Cysteine protease inhibitor C | 1.09 ± 0.34 | 1.19 (0.59, 2.39) | 0.632 |
FT3 Free triiodothyrotropin | 4.71 ± 2.43 | 0.92 (0.71, 1.18) | 0.503 |
FTH Free thyroxine | 16.25 ± 3.91 | 1.02 (0.95, 1.08) | 0.605 |
TSH | 2.87 ± 5.46 | 0.99 (0.93, 1.06) | 0.756 |
HDL-C | 1.08 ± 0.27 | 1.11 (0.43, 2.90) | 0.827 |
LDL-C | 2.49 ± 0.83 | 0.80 (0.59, 1.10) | 0.178 |
Lipoprotein | 179.00 (93.00–342.00) | 1.00 (1.00, 1.00) | 0.206 |
K+ | 4.17 ± 0.41 | 0.77 (0.42, 1.41) | 0.396 |
LVEF | 57.16 ± 5.70 | 0.97 (0.95, 0.99) | 0.036 |
Na+ | 141.31 ± 2.71 | 0.97 (0.88, 1.06) | 0.466 |
TC | 4.27 ± 1.11 | 0.92 (0.72, 1.17) | 0.495 |
TG | 1.58 ± 1.02 | 1.08 (0.85, 1.37) | 0.513 |
UA | 298.99 ± 80.09 | 1.00 (1.00, 1.00) | 0.294 |
Urea | 5.41 ± 1.82 | 1.09 (0.96, 1.24) | 0.194 |
ACEI | |||
No | 343 (66.73%) | Reference | |
Yes | 171 (33.27%) | 0.95 (0.58, 1.55) | 0.834 |
ARB | |||
No | 422 (82.10%) | Reference | |
Yes | 92 (17.90%) | 1.44 (0.84, 2.48) | 0.190 |
Aspirin | |||
No | 8 (1.56%) | Reference | |
Yes | 506 (98.44%) | 1.10 (0.13, 9.39) | 0.934 |
b-blocker | |||
No | 105(20.43%) | Reference | |
Yes | 409 (79.57%) | 1.45 (0.79, 2.68) | 0.232 |
Clopidogrel | |||
No | 213 (41.44%) | Reference | |
Yes | 301 (58.56%) | 0.67 (0.42, 1.06) | 0.087 |
Nitrates | |||
No | 212 (41.25%) | Reference | |
Yes | 302 (58.75%) | 1.08 (0.66, 1.75) | 0.756 |
Stain | |||
No | 13 (2.53%) | Reference | |
Yes | 501 (97.47%) | 0.95 (0.20, 4.47) | 0.945 |
Ticagrelor | |||
No | 321 (62.45%) | Reference | |
Yes | 193 (37.55%) | 1.41 (0.88, 2.25) | 0.155 |
Results of unadjusted and adjusted binary logistic regression
Variable | Crude model (model 1) | Adjust I (model 2) | Adjust II (model 3) |
---|---|---|---|
SBP (mmHg) | 1.01 (1.00, 1.03) 0.107 | 1.01 (1.00, 1.03) 0.125 | 1.01 (0.99, 1.03) 0.202 |
SBP (mmHg) Tertile | |||
84–118 | Reference | Reference | Reference |
119–133 | 1.32 (0.76, 2.31) 0.324 | 1.37 (0.78, 2.40) 0.271 | 1.27 (0.65, 2.48) 0.481 |
134–168 | 1.36 (0.78, 2.37) 0.274 | 1.33 (0.76, 2.33) 0.314 | 1.37 (0.70, 2.68) 0.362 |
P for trend | 1.16 (0.88, 1.53) 0.279 | 1.15 (0.87, 1.51) 0.319 | 1.16 (0.83, 1.62) 0.374 |
Variable | Crude model (model 1) | Adjust I (model 2) | Adjust II (model 3) |
---|---|---|---|
DBP (mmHg) | 1.00 (0.98, 1.03) 0.867 | 1.01 (0.98, 1.03) 0.601 | 1.00 (0.97, 1.03) 0.977 |
DBP (mmHg) Tertile | |||
53–70 | Reference | Reference | Reference |
71–79 | 1.01 (0.58, 1.76) 0.980 | 1.08 (0.61, 1.89) 0.800 | 0.83 (0.43, 1.61) 0.015 |
80–105 | 1.23 (0.72, 2.12) 0.442 | 1.35 (0.78, 2.34) 0.286 | 1.13 (0.60, 2.11) 0.713 |
P for trend | 1.11 (0.85, 1.46) 0.436 | 1.16 (0.88, 1.53) 0.282 | 1.08 (0.78, 1.48) 0 |
Results of nonlinearity of blood pressure and MACE
Inflection point of platelets | Effect size | 95% CI | P value |
---|---|---|---|
< 121 | 1.09 | 1.01–1.18 | 0.029 |
≥ 121 | 1.00 | 0.98–1.02 | 0.820 |