To examine the association between stage 1 hypertension (at baseline and longitudinal change) defined by the 2017 ACC/AHA hypertension guidelines and risk of cardiovascular events in a Chinese Kailuan Cohort. A total of 97,126 active and retired workers aged 18 to 98 years free of cardiovascular disease at baseline were followed for up to 10 years in the Chinese Kailuan Cohort Study. Adjusted Cox proportional hazard models were used to estimate hazard ratios and 95% confidence intervals of cardiovascular events among different blood pressure categories. Participants with stage 1 hypertension at baseline accounted for 31.1% of the cohort. Compared with normal blood pressure (<120/80 mmHg), stage 1 hypertension had a significantly higher risk of cardiovascular events, cerebral infarction and cerebral hemorrhage, and the hazard ratios (95% confidence intervals) were 1.25 (1.11-1.40), 1.31 (1.13-1.52), and 1.45 (1.07-1.97), respectively. Over a four-year period, 43.1% of participants maintained stage 1 hypertension. Compared with the decreased blood pressure from stage 1 hypertension to normal blood pressure, the maintained stage 1 hypertension had a significantly higher risk of cardiovascular events and cerebral infarction, and the hazard ratios (95% confidence intervals) were 1.78 (1.16-2.72) and 1.94 (1.14-3.30), respectively. People with stage 1 hypertension defined by the 2017 ACC/AHA hypertension guidelines have a relatively high risk for cardiovascular events in northern China; they should be given appropriate antihypertensive interventions.
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