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Hypertension, concurrent cardiovascular risk factors and mortality: the Singapore Cardiovascular Cohort Study

J Lee1, S Ma, D Heng

  • 1Community, Occupational and Family Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. cofleejm@nus.edu.sg

Journal of Human Hypertension
|March 14, 2008
PubMed

Insights

Hypertension (HTN) significantly increases mortality risk, especially when combined with other cardiovascular disease (CVD) risk factors. Managing these combined risks is crucial for better health outcomes in hypertensive patients.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Current hypertension (HTN) guidelines emphasize assessing cardiovascular disease (CVD) risk factors for management.
  • Limited research exists on the outcomes of individuals with HTN and co-existing CVD risk factors in Asian populations.

Purpose of the Study:

  • To evaluate the impact of hypertension alone and in combination with other CVD risk factors on all-cause and CVD mortality.
  • To analyze mortality risks associated with HTN and specific CVD risk factors in an Asian cohort.

Main Methods:

  • Utilized data from three cross-sectional studies in Singapore (1982-1995) involving 5830 participants.
  • Followed participants for a mean of 14.1 years, linking to the National Death Register.
  • Employed Cox's proportional hazards model to calculate adjusted hazard ratios (HRs) for mortality risk.

Main Results:

  • Hypertensive individuals with fewer than two CVD risk factors had a 1.4-fold increased risk of all-cause mortality (HR 1.4; 95% CI 1.0-1.8).
  • Those with two or more CVD risk factors faced a 2.3-fold increased risk (HR 2.3; 95% CI 1.9-3.0), with similar trends for CVD mortality.
  • Smoking and diabetes posed the highest all-cause mortality risk in hypertensive individuals; elevated cholesterol, smoking, and diabetes were linked to the highest CVD mortality risk.

Conclusions:

  • Hypertension significantly elevates mortality risk, with risk escalating with the presence of additional CVD risk factors.
  • Identifying and managing co-existing CVD risk factors in hypertensive patients is critical for reducing mortality.
  • The study underscores the importance of comprehensive risk factor assessment and management in hypertension care.

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