Related Experiment Video

Updated: Jun 24, 2026

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Profiles of mortality among Chinese hypertensive patients in Hong Kong: a cohort study

J Y Jiang1, M C S Wong, X H Zhang

  • 1Faculty of Medicine, School of Public Health and Department of Community and Family Medicine, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, NT, Hong Kong, China.

Journal of Human Hypertension
|April 3, 2009
PubMed

Insights

This study found that major antihypertensive drug classes showed comparable risks for all-cause and cardiovascular mortality in Chinese patients. These real-world findings support current guidelines recommending various drug classes for initiating hypertension treatment.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Hypertension management involves selecting appropriate antihypertensive drug classes.
  • Understanding the comparative mortality profiles of different antihypertensive agents is crucial for clinical decision-making.
  • Existing guidelines suggest multiple drug classes are suitable for initiating hypertension pharmacotherapy.

Purpose of the Study:

  • To investigate the association between different antihypertensive drug classes and all-cause and cardiovascular mortality.
  • To compare the mortality profiles of alpha-blockers, thiazide diuretics, beta-blockers, calcium channel blockers (CCBs), and renin-angiotensin system (RAS) agents.
  • To evaluate these associations in a large Chinese population within a real-world primary care setting.

Main Methods:

  • A cohort study utilizing electronic patient records from Hong Kong's public primary care sector (January 2004-June 2007).
  • Included 18,338 patients newly prescribed one of five major antihypertensive drug classes without drug switching or discontinuation.
  • Cox proportional hazards regression analyses were used to evaluate odds ratios for all-cause and cardiovascular mortality.

Main Results:

  • A total of 823 deaths (4.5%) occurred during the study period.
  • Crude all-cause mortality was highest with alpha-blockers (6.2%) and CCBs (5.7%), and lowest with beta-blockers (2.8%).
  • While thiazide diuretics showed statistically significantly lower all-cause and CVS mortality compared to CCBs, the 95% confidence intervals for mortality odds ratios overlapped across major drug classes, indicating comparable risks.

Conclusions:

  • Antihypertensive drug classes were associated with statistically comparable odds of all-cause and cardiovascular mortality in this Chinese population.
  • These real-life clinical practice findings support international guidelines recommending the suitability of major antihypertensive drug classes for initiating pharmacotherapy.
  • The study reinforces the principle that various first-line antihypertensive agents can be effectively used for managing hypertension.

Related Concept Videos

Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...
Hypertension I: Introduction01:28

Hypertension I: Introduction

Hypertension is a widespread, long-term medical condition where blood pressure in the arteries remains elevated. It is characterized by systolic blood pressure readings of 130 mm Hg or above or diastolic blood pressure (DBP) readings of 80 mm Hg or higher. Unmanaged hypertension poses significant health risks, making the distinction between primary (or essential) hypertension and secondary hypertension crucial, as their management and implications vary.Primary HypertensionPrimary hypertension,...
Hypertension II: Pathophysiology01:29

Hypertension II: Pathophysiology

Hypertension is a chronic condition in which the blood's force against artery walls is excessively high, posing risks such as heart disease. The condition's underlying mechanisms involve complex interactions among the cardiovascular, kidney, and autonomic nervous systems.Renin-Angiotensin-Aldosterone System (RAAS): This system significantly influences blood pressure regulation. When blood pressure decreases, the kidneys secrete renin. This enzyme transforms angiotensinogen, a plasma protein,...
Factors affecting Blood pressure01:28

Factors affecting Blood pressure

Several physiological and lifestyle factors influence blood pressure (BP). Understanding these factors is crucial as they are significant in patient education and blood pressure management.
Physiological Factors:
Hypertension V: Nursing Management01:23

Hypertension V: Nursing Management

The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.