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Treatment of uncomplicated hypertension is associated with a reduction in cardiovascular mortality: a Korean national cohort study

Authors
 Lee, Chan J  ;  Hwang, Jinseub  ;  Oh, Jaewon  ;  Lee, Sang-Hak  ;  Kang, Seok-Min  ;  Choi, Donghoon  ;  Kim, Hyeon-Chang  ;  Park, Sungha 
Citation
 JOURNAL OF HYPERTENSION, Vol.35(Suppl. 1) : 41-49, 2017 
Journal Title
 JOURNAL OF HYPERTENSION 
ISSN
 0263-6352 
Issue Date
2017
MeSH
Adrenergic beta-Antagonists/therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Antihypertensive Agents/therapeutic use* ; Calcium Channel Blockers/therapeutic use ; Cause of Death* ; Cohort Studies ; Diuretics/therapeutic use ; Female ; Humans ; Hypertension/drug therapy* ; Hypertension/mortality* ; Male ; Middle Aged ; Proportional Hazards Models ; Republic of Korea/epidemiology ; Young Adult
Keywords
antihypertensive agents ; cohort ; hypertension treatment ; mortality ; uncomplicated hypertension
Abstract
BACKGROUND: Although the benefit of hypertension treatment is well established in high-risk patients, there is a paucity of evidence regarding the benefit of treatment in patients with uncomplicated hypertension. METHODS: Hypertensive adult patients were selected from the Korea National Health Insurance Sample Cohort in 2002 and were followed until 2013. Patients with a diagnosis of heart failure, coronary artery disease, stroke, malignancy, diabetes, or chronic kidney disease were excluded. Ultimately, 40 496 patients were divided into three groups: never-treated (N = 6756), treated-from-baseline (N = 28 443), and treated-during-follow-up (N = 5297). Five first-line antihypertensive agents were categorized into four classes: renin-angiotensin system blocker (RASB), beta-blocker, calcium channel blocker (CCB), and diuretics. All-cause mortality, cardiovascular mortality, and hazard ratio were determined. RESULTS: All-cause and cardiovascular mortality rates were significantly lower in both treatment groups than in the never-treated group (all log-rank P < 0.001). Treatment from baseline (hazard ratio = 0.49 for all-cause mortality and hazard ratio = 0.62 for cardiovascular mortality) and treatment started during follow-up (hazard ratio = 0.41 for all-cause mortality and hazard ratio = 0.44 for cardiovascular mortality) were independently associated with lower mortality on multivariable Cox analyses. Although RASB, beta-blocker, and CCB significantly reduced all-cause mortality, multivariable Cox analyses showed that RASB and CCB were closely associated with lower all-cause mortality. In terms of cardiovascular mortality, only CCB was associated with lower cardiovascular mortality on multivariable Cox analyses. CONCLUSION: Treatment of hypertension significantly reduces mortality in patients with uncomplicated hypertension.
Full Text
http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00004872-201705001-00007&D=ovft&PDF=y
DOI
10.1097/HJH.0000000000001331.
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154623
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