Does self-reported history of hypertension predict cardiovascular death? Comparison with blood pressure measurement in a 19-year prospective study.
OBJECTIVE
Hypertension as assessed by blood pressure (BP) measurement is one of the most important risk factors for cardiovascular diseases (CVD). Self-reported history of hypertension (self-reported HT) is an easy way to obtain information on BP and is known to have a certain sensitivity and high specificity for hypertension confirmed by BP measurement (confirmative HT). Thus, it might predict CVD mortality, but few studies have reported on this relationship.


METHODS
We followed 6427 participants aged 30-59 years without a history of CVD for 19 years. The multivariate-adjusted hazard ratio (HR) of CVD mortality was estimated by the Cox proportional hazard model.


RESULTS
The sensitivity and specificity of self-reported HT for confirmative HT were 52-65% and 95%, respectively. The multivariate-adjusted HR of self-reported HT for CVD death was 2.49 [95% confidence interval (CI) = 1.72-3.61]. Compared to participants with neither self-reported HT nor confirmative HT, those with confirmative HT showed a consistently higher HR for CVD mortality. Self-reported HT without confirmative HT was also significantly related to CVD mortality (HR = 2.10, 95% CI = 1.04-4.26). These tendencies were unchanged when we further adjusted for systolic BP (SBP) level. The age-adjusted mortality rate of individuals with self-reported HT corresponded to the age-adjusted mortality rate of individuals whose SBP was 160-179 mmHg.


CONCLUSIONS
Self-reported HT could screen one-half of the participants for confirmative HT and was significantly associated with CVD mortality. These results indicate that self-reported HT can be a useful tool to screen for individuals with high BP if it is difficult to perform BP measurements continuously among all members of a community.
Higashiyama
Aya
A
Department of Health Science, Shiga University of Medical Science, Ostu, Japan. ayaya@belle.shiga-med.ac.jp
Murakami
Yoshitaka
Y
Hozawa
Atsushi
A
Okamura
Tomonori
T
Hayakawa
Takehito
T
Kadowaki
Takashi
T
Kita
Yoshikuni
Y
Okayama
Akira
A
Ueshima
Hirotsugu
H
D000328:Adult; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000401:mortality; D007564:Japan / Q000453:epidemiology; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D011795:Surveys and Questionnaires