March 4, 1997Circulation
Hypertension and Borderline Isolated Systolic Hypertension Increase Risks of Cardiovascular Disease and Mortality in Male Physicians
Key result
Hypertension and borderline isolated systolic hypertension increased the risk of total cardiovascular disease (RR 1.92; 95% CI 1.70-2.18 and RR 1.32; 95% CI 1.09-1.59, respectively) in US men.
Why the study?
Do definite hypertension and borderline isolated systolic hypertension increase the risk of cardiovascular disease and mortality in apparently healthy men?
Population
18,682 apparently healthy US men, aged 40 to 84 years, participating in the Physicians' Health Study
Comparison
Definite hypertension and borderline isolated… vs Normotension (implied reference group)
Design
Cohort
Follow-up
mean 11.7 years
Authors
Discussion
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Member takes
Implication
May guide risk stratification in healthy men; leaves open causal effects and intervention benefits.
Key Points
- To examine the relationship between hypertension, borderline isolated systolic hypertension, and risks of cardiovascular disease and mortality.
- Prospective cohort study with a mean follow-up of 11.7 years.
- Involved 18,682 apparently healthy US men aged 40 to 84 years from the Physicians' Health Study.
- Main outcome measures included cardiovascular disease, myocardial infarction, stroke, cardiovascular death, and all-cause mortality.
- Hypertension associated with increased risk of total cardiovascular disease (RR 1.92; 95% CI, 1.70 to 2.18).
- Significant risks noted for myocardial infarction (RR 1.78; 95% CI, 1.49 to 2.13), stroke (RR 2.19; 95% CI, 1.78 to 2.69), and cardiovascular death (RR 2.10; 95% CI, 1.68 to 2.63).
- Borderline isolated systolic hypertension linked to a 32% increase in cardiovascular disease risk (RR 1.32; 95% CI, 1.09 to 1.59) and 56% increase in cardiovascular death risk (RR 1.56; 95% CI, 1.13 to 2.15).
Study Design
Type
Cohort (n=18,682)
Structured PICO
Do definite hypertension and borderline isolated systolic hypertension increase the risk of cardiovascular disease and mortality in apparently healthy men?
P
Population
18,682 apparently healthy US men, aged 40 to 84 years, participating in the Physicians' Health Study
I
Intervention
Definite hypertension and borderline isolated systolic hypertension
C
Comparator
Normotension (implied reference group)
O
Outcome
Total cardiovascular disease, myocardial infarction, stroke, cardiovascular death, and all-cause mortalityhard clinical
Main Result
Effect estimate: RR 1.92 (95% CI 1.70 to 2.18)
Both definite hypertension and borderline isolated systolic hypertension significantly increase the risk of cardiovascular disease and mortality in apparently healthy men.
Cite This Study
O’Donnell et al. (1997) conducted a cohort in Hypertension and borderline isolated systolic hypertension (n=18,682). Hypertension and borderline isolated systolic hypertension was evaluated on Total cardiovascular disease (RR 1.92, 95% CI 1.70 to 2.18). Hypertension and borderline isolated systolic hypertension increased the risk of total cardiovascular disease (RR 1.92; 95% CI 1.70-2.18 and RR 1.32; 95% CI 1.09-1.59, respectively) in US men.