Generational differences in longitudinal blood pressure trajectories by geographic region during socioeconomic transitions in China

OBJECTIVES: To examine generational differences in longitudinal blood pressure trajectories by region following socioeconomic transitions, which is important for establishing the population risk of cardiovascular diseases (CVDs). METHODS: With data from the China Health and Nutrition Survey (1991–2011), we used multilevel growth-curve models to estimate systolic/diastolic blood pressure (SBP/DBP) levels at the mean age and rates of change by cohort (born between 1931 and 1980), region, and sex. RESULTS: Younger cohorts generally had higher SBP/DBP levels at 44.5 years but lower growth rates in SBP/DBP than older cohorts. They became prehypertensive (SBP ≥ 120 mm Hg or DBP ≥ 80 mm Hg) at an earlier age. The upward shift of SBP/DBP trajectories across cohorts was more pronounced in the Coastal and Southern Mountainous Regions than the Northeastern and Inland Regions, and for males versus females. CONCLUSIONS: Younger cohorts have a longer lifetime duration of being susceptible to CVDs, posing warnings for an increased burden of CVDs. Generational differences in BP trajectories and geographic and sex variations in the cohort trends highlight the need for tailored interventions to tackle the generation, region, and sex-based risk of CVDs.