title: Hypertension control as predictor of mortality in treated men and women, followed for up to 30 years.
abstract: OBJECTIVE
  To examine the prognosis of treated, hypertensive individuals in the Reykjavik Study.
  
  
  METHODS
  A population-based longitudinal study of 9328 men and 10 062 women. Subjects were included in the study during the period 1967-1996. Two groups of treated, hypertensive subjects were defined at baseline: with controlled blood pressure and with uncontrolled blood pressure. Main outcome measures were cardiovascular disease (CVD) mortality and all-cause mortality.
  
  
  RESULTS
  Of the hypertensive men 24.8% were treated, and of those 38.3% were controlled, and of the hypertensive women 45.3% were treated, and of those 52.7% were controlled. Comparing treated and uncontrolled (systolic blood pressure (SBP) > or =160 mmHg and/or diastolic blood pressure (DBP) > or =95 mmHg) versus treated and controlled hypertensive subjects, followed for up to 30 years, the uncontrolled men and women were at significantly higher risk of CVD mortality, hazard ratio (HR) = 1.47 (95% confidence interval (CI): 1.06-2.02) and HR 1.70 (CI: 1.23-2.36), respectively, showing the benefit of hypertension control. The risk of all-cause mortality was increased for treated, uncontrolled men and women, compared with those who were treated and controlled, but did not reach significance. When analyzing blood pressure as a continuous variable among treated, hypertensive subjects, SBP was a better predictor than DBP of CVD mortality and all-cause mortality in women. This was not the case in men.
  
  
  CONCLUSIONS
  Control of blood pressure among hypertensive-treated subjects at baseline was associated with a lower risk of CVD mortality during follow-up. SBP was the single best predictor of CVD mortality and all-cause mortality in treated women. The uncontrolled women were at a higher risk than the uncontrolled men.
authors.affiliation: Department of Pharmacology and Toxicology, University of Iceland, Hagi, Hofsvallagata 53, IS-107 Reykjavik, Iceland.
authors.forename: Larus S
authors.initials: LS
authors.lastname: Gudmundsson
authors.forename: Magnus
authors.initials: M
authors.lastname: Johannsson
authors.forename: Gudmundur
authors.initials: G
authors.lastname: Thorgeirsson
authors.forename: Nikulas
authors.initials: N
authors.lastname: Sigfusson
authors.forename: Helgi
authors.initials: H
authors.lastname: Sigvaldason
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
mesh_terms: D001794:Blood Pressure / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D011446:Prospective Studies