Cardiovascular Drugs and Therapy

, Volume 19, Issue 3, pp 227–235

Hypertension Control as Predictor of Mortality in Treated Men and Women, Followed for up to 30 Years

  • Larus S. Gudmundsson
  • Magnus Johannsson
  • Gudmundur Thorgeirsson
  • Nikulas Sigfusson
  • Helgi Sigvaldason
  • Jacqueline C. M. Witteman
Pharmaco-Epidemiology

DOI: 10.1007/s10557-005-1643-0

Cite this article as:
Gudmundsson, L.S., Johannsson, M., Thorgeirsson, G. et al. Cardiovasc Drugs Ther (2005) 19: 227. doi:10.1007/s10557-005-1643-0

Abstract

Purpose: To examine the prognosis of treated, hypertensive individuals in the Reykjavik Study

Methods: A population-based longitudinal study of 9328 men and 10 062 women. Subjects were included in the study during the period 1967-1996. Two groups of treated, hypertensive subjects were defined at baseline: with controlled blood pressure and with uncontrolled blood pressure. Main outcome measures were cardiovascular disease (CVD) mortality and all-cause mortality.

Results: Of the hypertensive men 24.8% were treated, and of those 38.3% were controlled, and of the hypertensive women 45.3% were treated, and of those 52.7% were controlled. Comparing treated and uncontrolled (systolic blood pressure (SBP) ≥160 mmHg and/or diastolic blood pressure (DBP) ≥95 mmHg) versus treated and controlled hypertensive subjects, followed for up to 30 years, the uncontrolled men and women were at significantly higher risk of CVD mortality, hazard ratio (HR) = 1.47 (95% confidence interval (CI): 1.06-2.02) and HR 1.70 (CI: 1.23–2.36), respectively, showing the benefit of hypertension control. The risk of all-cause mortality was increased for treated, uncontrolled men and women, compared with those who were treated and controlled, but did not reach significance. When analyzing blood pressure as a continuous variable among treated, hypertensive subjects, SBP was a better predictor than DBP of CVD mortality and all-cause mortality in women. This was not the case in men.

Conclusions: Control of blood pressure among hypertensive-treated subjects at baseline was associated with a lower risk of CVD mortality during follow-up. SBP was the single best predictor of CVD mortality and all-cause mortality in treated women. The uncontrolled women were at a higher risk than the uncontrolled men.

Keywords

cardiovascular diseaseshypertensionlong-term prognosismenmortalitytreatmentwomen

Copyright information

© Springer Science + Business Media, Inc. 2005

Authors and Affiliations

  • Larus S. Gudmundsson
    • 1
  • Magnus Johannsson
    • 1
  • Gudmundur Thorgeirsson
    • 1
    • 2
  • Nikulas Sigfusson
    • 2
  • Helgi Sigvaldason
    • 2
  • Jacqueline C. M. Witteman
    • 3
  1. 1.Department of Pharmacology and ToxicologyUniversity of IcelandReykjavikIceland
  2. 2.Heart Preventive Clinic and Research InstituteIcelandic Heart AssociationReykjavikIceland
  3. 3.Department of Epidemiology and BiostatisticsErasmus Medical CenterRotterdamThe Netherlands