Baseline Serum Bilirubin and Risk of First Stroke in Hypertensive Patients. Issue 12 (16th June 2020)

• Record Type: Journal Article
• Authors: Wang, Jiancheng; Zhang, Xianglin; Zhang, Zhuxian; Zhang, Yuanyuan; Zhang, Jingping; Li, Huan; Li, Youbao; Wang, Binyan; Nie, Jing; Liang, Min; Wang, Guobao; Cai, Yefeng; Li, Jianping; Zhang, Yan; Huo, Yong; Cui, Yimin; Xu, Xiping; Qin, Xianhui
• Is Part Of: Journal of the American Heart Association. Volume 9:Issue 12(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-06-16
• Subjects: direct bilirubin -- first hemorrhagic stroke -- first ischemic stroke -- hypertension -- total bilirubin; Heart -- Diseases -- Periodicals; Cardiovascular system -- Diseases -- Periodicals; Cerebrovascular disease -- Periodicals; Cardiology -- Periodicals; 616.1
• DOI: 10.1161/JAHA.119.015799
• Languages: English
• ISSNs: 2047-9980

Abstract

Abstract : Background: Data on the association between serum bilirubin and the risk of stroke are limited and inconclusive. We aimed to evaluate the association between serum bilirubin and the risk of first stroke and to examine any possible effect modifiers in hypertensive patients. Methods and Results: Our study was a post hoc analysis of the CSPPT (China Stroke Primary Prevention Trial). A total of 19 906 hypertensive patients were included in the final analysis. Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% CIs for the risk of first stroke associated with serum bilirubin levels. The median follow‐up period was 4.5 years. When serum total bilirubin was assessed as tertiles, the adjusted HR of first ischemic stroke for participants in tertile 3 (12.9–34.1 μmol/L) was 0.75 (95% CI, 0.59–0.96), compared with participants in tertile 1 (<9.3 μmol/L). When direct bilirubin was assessed as tertiles, a significantly lower risk of first ischemic stroke was also found in participants in tertile 3 (2.5–24.8 μmol/L) (adjusted HR, 0.77; 95% CI, 0.60–0.98), compared with those in tertile 1 (<1.6 μmol/L). However, there was no significant association between serum total bilirubin (tertile 3 versus 1: adjusted HR, 1.45; 95% CI, 0.89–2.35) or direct bilirubin (tertile 3 versus 1: adjusted HR, 1.27; 95% CI, 0.76–2.11) and first hemorrhagic stroke. Conclusions: In this sample of Chinese hypertensive patients, there was a significant inverse association between serum total bilirubin or direct bilirubin and the risk of first ischemic stroke.