Treatment of uncomplicated hypertension is associated with a reduction in cardiovascularmortality: A Korean national cohort study

Chan J. Lee, Jinseub Hwang, Jaewon Oh, Sang Hak Lee, Seok Min Kang, Donghoon Choi, Hyeon Chang Kim, Sungha Park

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2 Citations (Scopus)

Abstract

Background: Although the benefit of hypertension treatment is well established in high-risk patients, there is a paucity of evidence regarding the benefit of treatment in patients with uncomplicated hypertension. Methods: Hypertensive adult patients were selected from the Korea National Health Insurance Sample Cohort in 2002 and were followed until 2013. Patients with a diagnosis of heart failure, coronary artery disease, stroke, malignancy, diabetes, or chronic kidney disease were excluded. Ultimately, 40 496 patients were divided into three groups: never-treated (N=6756), treated-frombaseline (N=28 443), and treated-during-follow-up (N=5297). Five first-line antihypertensive agents were categorized into four classes: renin-angiotensin system blocker (RASB), beta-blocker, calcium channel blocker (CCB), and diuretics. All-cause mortality, cardiovascular mortality, and hazard ratio were determined. Results: All-cause and cardiovascular mortality rates were significantly lower in both treatment groups than in the never-treated group (all log-rank P>0.001). Treatment from baseline (hazard ratio=0.49 for all-cause mortality and hazard ratio=0.62 for cardiovascular mortality) and treatment started during follow-up (hazard ratio=0.41 for all-cause mortality and hazard ratio=0.44 for cardiovascular mortality) were independently associated with lower mortality on multivariable Cox analyses. Although RASB, beta-blocker, and CCB significantly reduced all-cause mortality, multivariable Cox analyses showed that RASB and CCB were closely associated with lower all-cause mortality. In terms of cardiovascular mortality, only CCB was associated with lower cardiovascular mortality on multivariable Cox analyses. Conclusion: Treatment of hypertension significantly reduces mortality in patients with uncomplicated hypertension.

Original languageEnglish
Pages (from-to)S41-S49
JournalJournal of hypertension
Volume35
DOIs
Publication statusPublished - 2017 Jan 1

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Cohort Studies
Hypertension
Mortality
Calcium Channel Blockers
Therapeutics
Renin-Angiotensin System
National Health Programs
Korea
Chronic Renal Insufficiency
Diuretics
Antihypertensive Agents
Coronary Artery Disease
Heart Failure
Stroke

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Treatment of uncomplicated hypertension is associated with a reduction in cardiovascularmortality: A Korean national cohort study",
abstract = "Background: Although the benefit of hypertension treatment is well established in high-risk patients, there is a paucity of evidence regarding the benefit of treatment in patients with uncomplicated hypertension. Methods: Hypertensive adult patients were selected from the Korea National Health Insurance Sample Cohort in 2002 and were followed until 2013. Patients with a diagnosis of heart failure, coronary artery disease, stroke, malignancy, diabetes, or chronic kidney disease were excluded. Ultimately, 40 496 patients were divided into three groups: never-treated (N=6756), treated-frombaseline (N=28 443), and treated-during-follow-up (N=5297). Five first-line antihypertensive agents were categorized into four classes: renin-angiotensin system blocker (RASB), beta-blocker, calcium channel blocker (CCB), and diuretics. All-cause mortality, cardiovascular mortality, and hazard ratio were determined. Results: All-cause and cardiovascular mortality rates were significantly lower in both treatment groups than in the never-treated group (all log-rank P>0.001). Treatment from baseline (hazard ratio=0.49 for all-cause mortality and hazard ratio=0.62 for cardiovascular mortality) and treatment started during follow-up (hazard ratio=0.41 for all-cause mortality and hazard ratio=0.44 for cardiovascular mortality) were independently associated with lower mortality on multivariable Cox analyses. Although RASB, beta-blocker, and CCB significantly reduced all-cause mortality, multivariable Cox analyses showed that RASB and CCB were closely associated with lower all-cause mortality. In terms of cardiovascular mortality, only CCB was associated with lower cardiovascular mortality on multivariable Cox analyses. Conclusion: Treatment of hypertension significantly reduces mortality in patients with uncomplicated hypertension.",
author = "Lee, {Chan J.} and Jinseub Hwang and Jaewon Oh and Lee, {Sang Hak} and Kang, {Seok Min} and Donghoon Choi and Kim, {Hyeon Chang} and Sungha Park",
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Treatment of uncomplicated hypertension is associated with a reduction in cardiovascularmortality : A Korean national cohort study. / Lee, Chan J.; Hwang, Jinseub; Oh, Jaewon; Lee, Sang Hak; Kang, Seok Min; Choi, Donghoon; Kim, Hyeon Chang; Park, Sungha.

In: Journal of hypertension, Vol. 35, 01.01.2017, p. S41-S49.

Research output: Contribution to journalArticle

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T1 - Treatment of uncomplicated hypertension is associated with a reduction in cardiovascularmortality

T2 - A Korean national cohort study

AU - Lee, Chan J.

AU - Hwang, Jinseub

AU - Oh, Jaewon

AU - Lee, Sang Hak

AU - Kang, Seok Min

AU - Choi, Donghoon

AU - Kim, Hyeon Chang

AU - Park, Sungha

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Although the benefit of hypertension treatment is well established in high-risk patients, there is a paucity of evidence regarding the benefit of treatment in patients with uncomplicated hypertension. Methods: Hypertensive adult patients were selected from the Korea National Health Insurance Sample Cohort in 2002 and were followed until 2013. Patients with a diagnosis of heart failure, coronary artery disease, stroke, malignancy, diabetes, or chronic kidney disease were excluded. Ultimately, 40 496 patients were divided into three groups: never-treated (N=6756), treated-frombaseline (N=28 443), and treated-during-follow-up (N=5297). Five first-line antihypertensive agents were categorized into four classes: renin-angiotensin system blocker (RASB), beta-blocker, calcium channel blocker (CCB), and diuretics. All-cause mortality, cardiovascular mortality, and hazard ratio were determined. Results: All-cause and cardiovascular mortality rates were significantly lower in both treatment groups than in the never-treated group (all log-rank P>0.001). Treatment from baseline (hazard ratio=0.49 for all-cause mortality and hazard ratio=0.62 for cardiovascular mortality) and treatment started during follow-up (hazard ratio=0.41 for all-cause mortality and hazard ratio=0.44 for cardiovascular mortality) were independently associated with lower mortality on multivariable Cox analyses. Although RASB, beta-blocker, and CCB significantly reduced all-cause mortality, multivariable Cox analyses showed that RASB and CCB were closely associated with lower all-cause mortality. In terms of cardiovascular mortality, only CCB was associated with lower cardiovascular mortality on multivariable Cox analyses. Conclusion: Treatment of hypertension significantly reduces mortality in patients with uncomplicated hypertension.

AB - Background: Although the benefit of hypertension treatment is well established in high-risk patients, there is a paucity of evidence regarding the benefit of treatment in patients with uncomplicated hypertension. Methods: Hypertensive adult patients were selected from the Korea National Health Insurance Sample Cohort in 2002 and were followed until 2013. Patients with a diagnosis of heart failure, coronary artery disease, stroke, malignancy, diabetes, or chronic kidney disease were excluded. Ultimately, 40 496 patients were divided into three groups: never-treated (N=6756), treated-frombaseline (N=28 443), and treated-during-follow-up (N=5297). Five first-line antihypertensive agents were categorized into four classes: renin-angiotensin system blocker (RASB), beta-blocker, calcium channel blocker (CCB), and diuretics. All-cause mortality, cardiovascular mortality, and hazard ratio were determined. Results: All-cause and cardiovascular mortality rates were significantly lower in both treatment groups than in the never-treated group (all log-rank P>0.001). Treatment from baseline (hazard ratio=0.49 for all-cause mortality and hazard ratio=0.62 for cardiovascular mortality) and treatment started during follow-up (hazard ratio=0.41 for all-cause mortality and hazard ratio=0.44 for cardiovascular mortality) were independently associated with lower mortality on multivariable Cox analyses. Although RASB, beta-blocker, and CCB significantly reduced all-cause mortality, multivariable Cox analyses showed that RASB and CCB were closely associated with lower all-cause mortality. In terms of cardiovascular mortality, only CCB was associated with lower cardiovascular mortality on multivariable Cox analyses. Conclusion: Treatment of hypertension significantly reduces mortality in patients with uncomplicated hypertension.

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