Journal of Shandong University (Health Sciences) ›› 2023, Vol. 61 ›› Issue (8): 79-85.doi: 10.6040/j.issn.1671-7554.0.2023.0224

• 公共卫生与管理学 • Previous Articles    

Mediation effects of hypertension on the association between exposure to non-steroidal anti-inflammatory drugs and risk of cardio-cerebrovascular diseases in middle-aged and elderly people

YU Qingqing1, CHANG Kaifeng2, LI Jiqing1, ZHANG Kai1, FU Ping1,LIU Xiaowen1, ZHAO Yingqi1, XUE Fuzhong1   

  1. 1. Department of Biostatistics, School of Public Health, Shandong University, Jinan 250012, Shandong, China;
    2. Pingyi Center for Disease Control and Prevention, Pingyi 273300, Shandong, China
  • Published:2023-08-30

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Abstract: Objective To explore the mediation effects of hypertension on the association between exposure to non-steroidal anti-inflammatory drugs(NSAIDs)and the risk of cardio-cerebrovascular diseases. Methods A follow-up cohort was constructed based on Pingyi Collaboration Center of National Institute of Health and Medical Big Data. NSAIDs exposure was defined as annual cumulative dose ≥30 cDDDs. The association between NSAIDs and blood pressure and cardio-cerebrovascular diseases were assessed with generalized estimation equation model(GEE)and Cox proportional risk regression model. The mediating effects of hypertension were evaluated with Baron-Kenny method. Results A total of 81,791 subjects were involved. The median follow-up time was 4.25(IQR: 3.22-4.46)years, with 26,514 cardio-cerebrovascular disease outcomes. Multivariate GEE results showed that NSAIDs exposure was significantly associated with increased systolic blood pressure(β=0.98, 95%CI: 0.67-1.29), decreased diastolic blood pressure(β=-0.19, 95%CI: -0.37 - 0.01), and increased risk of hypertension(OR=1.13, 95%CI: 1.08-1.18). Multivariate Cox model showed that the HR of NSAIDs associated with cardio-cerebrovascular diseases, cerebrovascular diseases and cardiovascular diseases were 1.13(95%CI: 1.10-1.16), 1.13(95%CI: 1.09-1.17)and 1.17(95%CI: 1.13-1.21), respectively. Mediation analysis showed that hypertension played a partial mediating role in the relationship between NSAIDs exposure and cardio-cerebrovascular diseases, with a mediating proportion of 9.27%. Conclusion NSAIDs, which can increase systolic blood pressure and decrease diastolic blood pressure, is a risk factor for cardio-cerebrovascular diseases. Hypertension is a mediating factor between NSAIDs and cardio-cerebrovascular diseases.

Key words: Non-steroidal anti-inflammatory drugs, Hypertension, Cardio-cerebrovascular diseases, Cohort study, Mediating effects

CLC Number: 

  • R54
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