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Mortality in hypertensive patients in Hospitalet de Llobregat, Barcelona (Spain)
R Tresserras1, H Pardell, A Martinez-Amenos
1Public Health Division, Department of Health and Social Security, Generalitat de Catalunya, Barcelona, Spain.
Insights
Hypertensive patients face a significantly higher mortality risk compared to the general population. Factors like smoking, diabetes, and uncontrolled blood pressure further elevate this risk, particularly in older adults.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Hypertension is a prevalent condition globally.
- Understanding mortality differences between hypertensive individuals and the general population is crucial for public health strategies.
- Existing data may not fully capture the excess mortality risk in hypertensive cohorts compared to matched general populations.
Purpose of the Study:
- To compare the mortality rates of hypertensive patients with the general population in Hospitalet de Llobregat, Spain.
- To identify specific risk factors contributing to increased mortality among hypertensive individuals.
- To evaluate potential differences in mortality patterns between genders within the hypertensive cohort.
Main Methods:
- Retrospective cohort study involving 729 hypertensive patients (aged 40+) over a six-year period.
- Mortality data compared against a sex- and age-matched general population.
- Standardized mortality ratio (SMR) calculated to assess risk.
- Analysis of contributing factors including smoking, diabetes, hypertension control, and age.
Main Results:
- Hypertensive patients exhibited a significantly increased mortality risk (SMR 1.88; 95% CI 1.21-2.44) compared to the general population.
- Cardiovascular mortality was higher in males, while non-cardiovascular mortality was higher in females.
- Smoking, diabetes, uncontrolled hypertension, and age over 60 were associated with higher mortality risk in hypertensives.
Conclusions:
- Hypertensive individuals face a substantially elevated risk of death compared to their non-hypertensive peers.
- Specific risk factors like smoking, diabetes, and poor blood pressure control exacerbate mortality.
- Targeted interventions and improved hypertension management are essential to mitigate excess mortality in this population.
Abstract:
A retrospective cohort study was carried out on 729 hypertensive patients (male and female 40 years and older) in Hospitalet de Llobregat (Barcelona, Spain) to assess possible differences between the mortality of this group of hypertensives and the general population of the same area matched by age and sex. Patient mortality was assessed during a six year period, resulting in a mean follow-up of 2.6 years at the end of the study. The results reflect an increased risk of dying among hypertensives compared with the general population, with standardised mortality ratio by age and sex of 1.88 (95% confidence interval 1.21-2.44). Cardiovascular mortality was significantly higher for males, while noncardiovascular mortality was significantly higher for females. The study also shows that the presence of smoking habit, diabetes or hyperglycaemia, uncontrolled hypertension and age > or = 60 years can increase the risk of dying among hypertensive patients. Although a higher level of BP control is achieved in hypertension hospital clinics than in the primary health care system, the study shows that hypertensives have an excess of mortality than expected considering their own general population by age and sex.