Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://cr.elmerpub.com

Original Article

Volume 16, Number 4, August 2025, pages 357-365

Adverse Cardiovascular Events Are Infrequent but Significantly Associated With Systolic and Pre-Systolic Hypertension: An Occupational Cohort Study

**Table 1.** Study Sample Characteristics
Characteristic	N = 12,027
Data were presented as n (%) or mean (SD).
Sex
Female	1,820 (15.13%)
Male	10,207 (84.87%)
Age, mean (SD)	37.19 (11.56)
Age group
18 - 59 years	11,487 (95.51%)
60 years or older	540 (4.49%)
Smoking status
No	7,097 (59.01%)
Yes	4,930 (40.99%)
Alcohol consumption
No	6,020 (50.05%)
Yes	6,007 (49.95%)
Body mass index	27.15 (3.99)
Systolic blood pressure	111.27 (12.26)
Diastolic blood pressure	71.94 (13.35)
Blood glucose level	92.44 (20.81)
Triglyceride level	143.67 (80.99)
Cholesterol level	194.81 (36.82)
Nutritional status
Normal weight	3,650 (30.35%)
Overweight	5,784 (48.09%)
Obesity	2,593 (21.56%)
Blood glucose levels at baseline
Normal glucose	8,446 (82.69%)
Prediabetes	1,520 (14.88%)
Diabetes	248 (2.43%)
Hypertriglyceridemia
No	3,769 (63.55%)
Yes	2,162 (36.45%)
Hypercholesterolemia
No	3,434 (58.21%)
Yes	2,465 (41.79%)
Isolated systolic prehypertension
No	70,393 (89.80%)
Yes	7,997 (10.20%)
Isolated diastolic prehypertension
No	70,932 (90.49%)
Yes	7,458 (9.51%)
Systolic-diastolic prehypertension
No	69,497 (88.66%)
Yes	8,893 (11.34%)
Isolated systolic hypertension
No	11,934 (99.23%)
Yes	93 (0.77%)
Isolated diastolic hypertension
No	11,747 (97.67%)
Yes	280 (2.33%)
Systolic-diastolic hypertension
No	11,866 (98.66%)
Yes	161 (1.34%)

Table 1. Study Sample Characteristics

Characteristic

N = 12,027

Data were presented as n (%) or mean (SD).

Sex

Female

1,820 (15.13%)

Male

10,207 (84.87%)

Age, mean (SD)

37.19 (11.56)

Age group

18 - 59 years

11,487 (95.51%)

60 years or older

540 (4.49%)

Smoking status

7,097 (59.01%)

Yes

4,930 (40.99%)

Alcohol consumption

6,020 (50.05%)

Yes

6,007 (49.95%)

Body mass index

27.15 (3.99)

Systolic blood pressure

111.27 (12.26)

Diastolic blood pressure

71.94 (13.35)

Blood glucose level

92.44 (20.81)

Triglyceride level

143.67 (80.99)

Cholesterol level

194.81 (36.82)

Nutritional status

Normal weight

3,650 (30.35%)

Overweight

5,784 (48.09%)

Obesity

2,593 (21.56%)

Blood glucose levels at baseline

Normal glucose

8,446 (82.69%)

Prediabetes

1,520 (14.88%)

Diabetes

248 (2.43%)

Hypertriglyceridemia

3,769 (63.55%)

Yes

2,162 (36.45%)

Hypercholesterolemia

3,434 (58.21%)

Yes

2,465 (41.79%)

Isolated systolic prehypertension

70,393 (89.80%)

Yes

7,997 (10.20%)

Isolated diastolic prehypertension

70,932 (90.49%)

Yes

7,458 (9.51%)

Systolic-diastolic prehypertension

69,497 (88.66%)

Yes

8,893 (11.34%)

Isolated systolic hypertension

11,934 (99.23%)

Yes

93 (0.77%)

Isolated diastolic hypertension

11,747 (97.67%)

Yes

280 (2.33%)

Systolic-diastolic hypertension

11,866 (98.66%)

Yes

161 (1.34%)

**Table 2.** Incidence Rates and Risk of Cardiovascular Events According to Arterial Prehypertension Subtypes in Workers From an Occupational Cohort
Prehypertension	Incidence per 1,000 person-years (95% CI)	Number of cases	Follow-up time (years)	Univariable	Multivariable^a
^aModel adjusted for sex, age, smoking status, alcohol consumption, nutritional status, glycemia level, hypertriglyceridemia, hypercholesterolemia. aHR: adjusted hazard ratio; cHR: crude hazard ratio; CI: confidence interval.
Isolated systolic prehypertension
No	1.69 (1.24 - 2.15)	53	31,274.34	Ref.		Ref.
Yes	40.67 (12.49 - 68.85)	8	196.72	3.88	2.12 - 7.09	3.42	1.73 - 6.74
Isolated diastolic prehypertension
No	2.07 (1.55 - 2.60)	60	28,921.58	Ref.		Ref.
Yes	0.39 (0.01 - 1.16)	1	2,549.48	0.24	0.03 - 1.71	-	-
Systolic-diastolic prehypertension
No	1.80 (1.29 - 2.30)	49	27,285.89	Ref.		Ref.
Yes	2.87 (1.24 - 4.49)	5	4,185.17	2.1	1.09 - 4.04	0.87	0.40 - 1.93

Table 2. Incidence Rates and Risk of Cardiovascular Events According to Arterial Prehypertension Subtypes in Workers From an Occupational Cohort

Prehypertension

Incidence per 1,000 person-years (95% CI)

Number of cases

Follow-up time (years)

Univariable

Multivariable^a

cHR

95% CI

aHR

95% CI

Isolated systolic prehypertension

1.69 (1.24 - 2.15)

31,274.34

Ref.

Yes

40.67 (12.49 - 68.85)

196.72

3.88

2.12 - 7.09

3.42

1.73 - 6.74

Isolated diastolic prehypertension

2.07 (1.55 - 2.60)

28,921.58

Ref.

Yes

0.39 (0.01 - 1.16)

2,549.48

0.24

0.03 - 1.71

Systolic-diastolic prehypertension

1.80 (1.29 - 2.30)

27,285.89

Ref.

Yes

2.87 (1.24 - 4.49)

4,185.17

2.1

1.09 - 4.04

0.87

0.40 - 1.93

**Table 3.** Incidence Rates and Risk of Cardiovascular Events According to Arterial Hypertension Subtypes in Workers From an Occupational Cohort
	Incidence per 1,000 person-years (95% CI)	Number of cases	Follow-up time (years)	Univariable	Multivariable^a
^aModel adjusted for sex, age, smoking status, alcohol consumption, nutritional status, glycemia level, hypertriglyceridemia, hypercholesterolemia. aHR: adjusted hazard ratio; cHR: crude hazard ratio; CI: confidence interval; IDH: isolated diastolic hypertension; ISH: isolated systolic hypertension; SDH: systolic-diastolic hypertension.
ISH
No	1.69 (1.24 - 2.15)	53	27,930.22	Ref.		Ref.
Yes	4.52 (2.30 - 6.73)	16	3,540.84	20.2	9.95 - 40.9	6.78	3.10 - 14.8
IDH
No	2.07 (1.55 - 2.60)	60	28,921.58	Ref.		Ref.
Yes	0.39 (0.01 - 1.16)	1	2,549.48	0.50	0.07 - 3.62	0.33	0.05 - 2.42
SDH
No	1.80 (1.33 - 2.27)	56	27,285.89	Ref.		Ref.
Yes	2.87 (1.24 - 4.49)	12	4,185.17	6.61	2.85 - 15.3	1.42	0.56 - 3.59

Table 3. Incidence Rates and Risk of Cardiovascular Events According to Arterial Hypertension Subtypes in Workers From an Occupational Cohort

Incidence per 1,000 person-years (95% CI)

Number of cases

Follow-up time (years)

Univariable

Multivariable^a

cHR

95% CI

aHR

95% CI

^aModel adjusted for sex, age, smoking status, alcohol consumption, nutritional status, glycemia level, hypertriglyceridemia, hypercholesterolemia. aHR: adjusted hazard ratio; cHR: crude hazard ratio; CI: confidence interval; IDH: isolated diastolic hypertension; ISH: isolated systolic hypertension; SDH: systolic-diastolic hypertension.

ISH

1.69 (1.24 - 2.15)

27,930.22

Ref.

Yes

4.52 (2.30 - 6.73)

3,540.84

20.2

9.95 - 40.9

6.78

3.10 - 14.8

IDH

2.07 (1.55 - 2.60)

28,921.58

Ref.

Yes

0.39 (0.01 - 1.16)

2,549.48

0.50

0.07 - 3.62

0.33

0.05 - 2.42

SDH

1.80 (1.33 - 2.27)

27,285.89

Ref.

Yes

2.87 (1.24 - 4.49)

4,185.17

6.61

2.85 - 15.3

1.42

0.56 - 3.59