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We aimed to study whether there was a blood pressure range that was positively associated with stroke or coronary heart disease compared with other levels in the so-called normotensives with or without diabetes mellitus and intermediate or high risk-factor burden.

Design and Method:

We enrolled 42959 persons aged 35–70 years old between 2005 and 2009 from 70 rural and 45 urban communities in China, and assessed their cardiovascular risk-factor burden using the validated INTERHEART Risk Score. To enable comparisons between subgroups, we adjusted for age, sex, rural or urban, education, family history of cardiovascular disease, HDL-C, LDL-C, triglyceride and waist-hip ratio where appropriate using generalized linear model in SAS.


Among 18537 (43.15%total population) hypertensives, 10503 (56.66%) participants were in intermediate or high risk range according to the INTERHEART risk score. In the 3984 (9.27%total population) diabetes participants, there were 2545 (56.66%)hypertensives. We subdivided the non-hypertensives (56.85% overall subjects)into three groups, namely systolic blood pressure≥130 mmHg or diastolic blood pressure≥85 mmHg (24.86%), SBP < 130 but ≥120 mmHg and DBP<85 but ≥80 mmHg (32.81%), SBP<120 and DBP<80 mmHg (42.32%). The odds ratios of self-reported stroke and coronary heart disease after adjusted among the three subgroups were not significantly different from each other no matter in the overall population or in the non-diabetes or diabetes subjects or the medium and high-risk participants. Whereas compared with the third non-hypertensive subgroup, the odds of self-reported stroke in the hypertensives were 2.796 (95% CI:2.166–3.609, P < 0.0001), 2.687 (95% CI:2.044–3.532, P < 0.0001), 3.122 (95% CI:1.506–6.472, P = 0.0022), 3.713 (95% CI:2.509–5.494, P < 0.0001) respectively in the overall population and the non-diabetes and diabetes subjects and the medium or high risk participants; the odds of self-reported coronary heart disease in the hypertensives were 1.790 (95% CI:1.559–2.055, P < 0.0001), 1.716 (95% CI:1.482–1.987, P < 0.0001), 2.142 (95% CI:1.392–3.296, P = 0.0005), 2.205 (95% CI:1.780–2.732, P < 0.0001) respectively.


Hypertension was significantly associated with stroke and coronary heart disease, especialy stroke, in different population. In diabetes and intermediate or high-risk subjects, the risk of hypertension for stroke and coronary heart disease was even aggravated. In different population, we didn’t discover that the three blood pressure subgroups in non-hypertensives were significantly associated with stroke or coronary heart disease.

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