Foti Kathryn, Colantonio Lisandro D, Huang Lei, Plante Timothy B, Ghazi Lama, Hardy Shakia T, Levitan Emily B, Safford Monika M, Muntner Paul
Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama.
Department of Medicine, Larner College of Medicine at the University of Vermont, Burlington, Vermont.
Am J Hypertens. 2025 Jun 28. doi: 10.1093/ajh/hpaf115.
A substantial proportion of adults with hypertension die from causes other than cardiovascular disease (CVD), but the frequencies are unknown.
We calculated the frequency of causes of death for adults with and without hypertension using data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, which enrolled non-Hispanic Black and White adults aged ≥45 years in 2003-2007. Participants were followed until death or December 31, 2019. Blood pressure (BP) was measured at baseline and at a follow-up examination in 2013-2016. Hypertension was defined as systolic BP ≥130 mmHg or diastolic BP ≥80 mmHg, or self-reported antihypertensive medication use, and modeled a time-varying exposure. The outcome was the adjudicated underlying cause of death, determined from all available information including death certificates, medical records, autopsy reports, and interviews with proxies or next of kin.
There were 8,933 deaths among 23,622 participants with hypertension and 1,709 deaths among 5,744 participants without hypertension over a median 8.1 years of follow up. Among participants who died, the most common causes of death were CVD (31.2%), cancer (22.1%), and infection (11.6%) among participants with hypertension and cancer (29.8%), CVD (23.2%), and dementia (11.8%) among participants without hypertension. Among participants with and without hypertension, the 10-year cumulative incidence was 8.2% and 3.6% for CVD mortality, respectively, 5.8% and 4.9% for cancer mortality, and 2.8% and 1.5% for infection mortality, respectively.
Among adults with hypertension, a majority of deaths were from non-CVD causes, including one-third of deaths from cancer and infection.
相当一部分高血压成年人死于心血管疾病（CVD）以外的原因，但其发生频率尚不清楚。
我们利用中风地理和种族差异原因（REGARDS）研究的数据，计算了有高血压和无高血压成年人的死因频率。该研究在2003年至2007年招募了年龄≥45岁的非西班牙裔黑人和白人成年人。对参与者进行随访直至死亡或2019年12月31日。在基线和2013年至2016年的随访检查中测量血压。高血压定义为收缩压≥130 mmHg或舒张压≥80 mmHg，或自我报告使用抗高血压药物，并将其建模为随时间变化的暴露因素。结局为判定的根本死因，根据包括死亡证明、病历、尸检报告以及与代理人或近亲访谈在内的所有可用信息确定。
在中位8.1年的随访期内，23622名高血压参与者中有8933人死亡，5744名无高血压参与者中有1709人死亡。在死亡的参与者中，高血压参与者最常见的死因是CVD（31.2%）、癌症（22.1%）和感染（11.6%），无高血压参与者最常见的死因是癌症（29.8%）、CVD（23.2%）和痴呆（11.8%）。在有高血压和无高血压的参与者中，CVD死亡率的10年累积发病率分别为8.2%和3.6%，癌症死亡率分别为5.8%和4.9%，感染死亡率分别为2.8%和1.5%。
在高血压成年人中，大多数死亡是由非CVD原因导致的，包括三分之一的癌症和感染死亡。
