Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
Department of Nutrition, Bjørknes University College, Oslo, Norway.
Biomed Res Int. 2021 Jul 12;2021:9376134. doi: 10.1155/2021/9376134. eCollection 2021.
Few studies have assessed the association between hypertension and risk of detailed causes of death. We investigated the association between hypertension and all-cause mortality and 67 causes of death in a large cohort.
Multivariable Cox regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for self-reported hypertension vs. no hypertension and mortality. Adults aged ≥18 years ( = 213798) were recruited in 1997-2004 and followed through December 31, 2006.
During 5.81 years of follow-up, 11254 deaths occurred. Self-reported hypertension vs. no hypertension was associated with increased risk of all-cause mortality (HR = 1.25, 95% CI: 1.19-1.31) and mortality from septicemia (HR =1.66, 1.06-2.59), other infectious parasitic diseases (HR = 2.67, 1.09-6.51), diabetes mellitus (HR = 1.97, 1.45-2.67), circulatory disease (HR = 1.49, 1.37-1.61), hypertensive heart disease (HR = 3.23, 2.00-5.20), ischemic heart disease (HR = 1.35, 1.23-1.49), acute myocardial infarction (HR = 1.50, 1.27-1.77), other chronic ischemic heart diseases (HR = 1.35, 1.17-1.56), all other forms of heart disease (HR = 1.51, 1.21-1.89), primary hypertension and renal disease (HR = 3.11, 1.82-5.30), cerebrovascular disease (HR = 1.64, 1.37-1.97), other circulatory system diseases (HR = 1.71, 1.09-2.69), other chronic lower respiratory diseases (HR = 1.39, 1.12-1.73), other chronic liver disease (HR = 1.89, 1.06-3.37), renal failure (HR = 1.91, 1.33-2.74), motor vehicle accidents (HR = 1.60, 1.07-2.37), and all other diseases (HR =1.30, 1.10-1.54), but with lower risk of uterine cancer (HR = 0.37, 95% CI: 0.15-0.90) and Alzheimer's disease (HR = 0.65, 95% CI: 0.47-0.92).
Hypertension was associated with increased risk of all-cause mortality and 17 out of 67 causes of death, with most of these being circulatory disease outcomes, however, some of the remaining associations are unlikely to be causal. Further studies are needed to clarify associations with less common causes of death and potential causality across outcomes.
很少有研究评估高血压与各种死因之间的关系。我们在一个大型队列中研究了高血压与全因死亡率和 67 种死因之间的关系。
多变量 Cox 回归模型用于估计自我报告的高血压与无高血压以及死亡率之间的危险比（HR）和 95%置信区间（95%CI）。1997-2004 年招募了年龄≥18 岁（=213798 人）的成年人，并随访至 2006 年 12 月 31 日。
在 5.81 年的随访期间，发生了 11254 例死亡。与无高血压相比，自我报告的高血压与全因死亡率（HR=1.25，95%CI：1.19-1.31）和败血症（HR=1.66，1.06-2.59）、其他传染性寄生虫病（HR=2.67，1.09-6.51）、糖尿病（HR=1.97，1.45-2.67）、循环系统疾病（HR=1.49，1.37-1.61）、高血压性心脏病（HR=3.23，2.00-5.20）、缺血性心脏病（HR=1.35，1.23-1.49）、急性心肌梗死（HR=1.50，1.27-1.77）、其他慢性缺血性心脏病（HR=1.35，1.17-1.56）、其他形式的心脏病（HR=1.51，1.21-1.89）、原发性高血压和肾脏疾病（HR=3.11，1.82-5.30）、脑血管病（HR=1.64，1.37-1.97）、其他循环系统疾病（HR=1.71，1.09-2.69）、其他慢性下呼吸道疾病（HR=1.39，1.12-1.73）、其他慢性肝病（HR=1.89，1.06-3.37）、肾衰竭（HR=1.91，1.33-2.74）、机动车事故（HR=1.60，1.07-2.37）和其他所有疾病（HR=1.30，1.10-1.54），但子宫癌（HR=0.37，95%CI：0.15-0.90）和阿尔茨海默病（HR=0.65，95%CI：0.47-0.92）的风险较低。
高血压与全因死亡率和 67 种死因中的 17 种死因的风险增加有关，其中大多数是循环系统疾病，但其中一些剩余的关联不太可能是因果关系。需要进一步的研究来阐明与不太常见的死因和潜在因果关系的结果之间的关联。
