Survival in patients with hypertension treated in primary care. A population-based follow-up study in the Skaraborg Hypertension and Diabetes Project.
OBJECTIVE
To explore risk factors for all-cause mortality in patients with hypertension.


METHODS
Community-based cohort study.


METHODS
Hypertension outpatient clinic in primary health care.


METHODS
Hypertensive men and women who consecutively underwent an annual follow-up during 1992--1993 (n =894).


METHODS
Vital status was ascertained up to December 1999 by record linkage with national registers. Gender-specific predictors for mortality from baseline examination were analysed by Cox regression.


METHODS
All-cause mortality.


RESULTS
In both sexes all-cause mortality was predicted by fasting blood glucose (RR by 1 mmol L(-1): 1.2, CI: 1.1-1.3 in men; 1.2, 1.1-1.4 in women), and known type 2 diabetes (RR: 1.9, CI: 1.3-2.9 in men; 2.5, 1.7-3.9 in women). In men, furthermore, mortality was predicted by previous cardiovascular disease, left ventricular hypertrophy and microalbuminuria, whilst in women mortality was predicted by high blood pressure and dyslipidemia. In patients without known diabetes male gender was a strong predictor of mortality (RR: 2.0, CI: 1.4-2.9), whereas in patients with hypertension and type 2 diabetes combined, male gender was not associated with increased mortality (RR: 1.4, CI: 0.9-2.2).


CONCLUSIONS
Type 2 diabetes in hypertensive patients treated in primary care predicts mortality and dilutes gender difference in survival. For hypertensive patients general practitioners should be observant regarding disturbed glucose metabolism and regarding the associated major risk increase in women.
Bøg-Hansen
Erik
E
Department of Community Medicine, Malmö University Hospital, Malmö, Sweden. erik.bog-hansen@vgregion.se
Merlo
Juan
J
Gullberg
Bo
B
Melander
Arne
A
Råstam
Lennart
L
Lindblad
Ulf
U
D000368:Aged; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011320:Primary Health Care; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis; D013548:Sweden / Q000453:epidemiology