Abstract
BACKGROUND: This study aimed to prospectively assess the relationship between systolic blood pressure (SBP) trajectories and successful aging in middle-aged and elderly Chinese individuals. METHODS: A total of 1,960 participants from the China Health and Retirement Longitudinal Study (CHARLS) were included. SBP measurements from 2011, 2013, and 2015 were used to identify trajectory patterns via a latent category trajectory model (LCTM). Successful aging was assessed in 2020 and defined as the absence of major chronic diseases, preserved physical function, high cognitive performance, favorable mental health, and active social engagement. Logistic regression was applied to evaluate associations between SBP trajectories and successful aging. RESULTS: Three SBP trajectories were identified: stable low, stable high, and unstable high. Over the 9-year follow-up, 89 participants (4.5%) met the criteria for successful aging. Compared with the stable low group, adjusted odds ratios (95% CI) for successful aging were 0.490 (0.293-0.817) for the stable high group and 0.099 (0.014-0.727) for the unstable high group. Stratified and sensitivity analyses supported these findings. CONCLUSIONS: Both stable high and unstable high SBP trajectories were significantly associated with reduced likelihood of successful aging. These findings highlight the importance of longitudinal SBP monitoring in promoting healthy aging in midlife and beyond.