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Published on: September 26, 2018

Risk-factor clustering and cardiovascular disease risk in hypertensive patients

Derek Weycker1, Gregory A Nichols, Maureen O'Keeffe-Rosetti

  • 1Policy Analysis, Inc., Brookline, Massachusetts 02445, USA. dweycker@pai2.com

American Journal of Hypertension
|May 29, 2007
PubMed

Insights

Over half of patients with hypertension have additional cardiovascular disease risk factors like diabetes. These patients face significantly higher risks and medical costs, especially those with diabetes.

Area of Science:

  • Cardiology
  • Public Health
  • Health Economics

Background:

  • Hypertension is a common condition often co-occurring with other cardiovascular disease (CVD) risk factors.
  • Limited understanding exists regarding the clustering of these risk factors in hypertensive patients and their impact on CVD risk and healthcare expenditures.

Purpose of the Study:

  • To investigate the extent of risk-factor clustering in patients with hypertension.
  • To determine the association between these risk-factor clusters and the risk of cardiovascular events.
  • To analyze the impact of risk-factor clustering on medical-care costs.

Main Methods:

  • Utilized electronic medical records from Kaiser Permanente Northwest for patients aged >=35 with hypertension and no prior CVD in 1998.
  • Stratified 57,573 patients into eight clusters based on diabetes, hyperlipidemia, and high body mass index (BMI).
  • Examined 6-year risk of cardiovascular events using Kaplan-Meier and Cox proportional hazards models, alongside cumulative medical costs.

Main Results:

  • 56% of hypertensive patients had comorbid diabetes, hyperlipidemia, or high BMI.
  • Controlling for age, sex, and smoking, comorbid diabetes significantly elevated CVD risk (RR 2.07-2.80).
  • Medical costs increased with additional risk factors, with diabetes having the most substantial impact.

Conclusions:

  • A significant proportion of hypertensive patients exhibit clustered risk factors, particularly diabetes.
  • These clustered risk factors, especially diabetes, are associated with substantially increased cardiovascular risk and healthcare costs.
Abstract

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