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Risk factor heterogeneity across cardiovascular disease outcomes in treatment-eligible hypertensive patients

Olivia Gästgivars1, Urban Wiklund2, Mattias Brunström1

  • 1Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.

Journal of Hypertension
|March 24, 2026
PubMed

Insights

Hypertension risk factors differ for acute coronary syndrome (ACS), stroke, and heart failure. Understanding this heterogeneity is key for personalized cardiovascular disease prevention in hypertensive patients.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Epidemiology

Background:

  • Precision medicine requires understanding specific cardiovascular outcome risks in hypertension.
  • Heterogeneity in risk factors for acute coronary syndrome (ACS), stroke, and heart failure needs exploration.

Purpose of the Study:

  • To investigate the varying associations of traditional cardiovascular risk factors with ACS, stroke, and heart failure.
  • To identify differences in risk factor impact across distinct cardiovascular events in hypertensive individuals.

Main Methods:

  • Population-based cohort study in Sweden (Västerbotten) including middle-aged, treatment-eligible hypertensive patients.
  • Analysis of traditional cardiovascular risk factors and their association with ACS, stroke, and heart failure over 10 years.
  • Multinomial logistic regression used to calculate standardized odds ratios.

Main Results:

  • Over 10 years, 1190 cardiovascular events occurred in 12,238 participants.
  • Risk factor associations varied in magnitude across outcomes: total cholesterol linked to ACS but not stroke/heart failure; smoking/male sex stronger for ACS; BMI/socioeconomic factors for heart failure; diabetes/DBP stronger for stroke.

Conclusions:

  • Clinically significant differences exist in how risk factors associate with ACS, stroke, and heart failure in hypertensive patients.
  • Current models are inadequate for treatment guidance; further research into outcome-specific risk factor heterogeneity is warranted.
Abstract

Keywords:
acute coronary syndromecardiovascular diseaseheart failurehypertensionprecision medicinerisk factorsstroke

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