Journal of Hypertension, Volume 35, Supplement 1, 1 May 2017, pp. S41-S49(9)

 

Treatment of uncomplicated hypertension is associated

with a reduction in cardiovascularmortality: a Korean

national cohort study

Lee Chan J, Hwang, Jinseub, Oh, Jaewon, Lee, Sang-Hak, Kang, Seok-Min, Choi, Donghoon, Kim, Hyeon Chang, Park, Sungha

 

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.



Keywords: antihypertensive agents, cohort, hypertension treatment, mortality, uncomplicated hypertension