title: Prediction of all-cause mortality in a patient population with hypertension and type 2 DM by using traditional risk factors and serum-phosphate,-calcium and-magnesium.
abstract: The aim of this study is to investigate whether the prediction of all-cause mortality from traditional risk factors is improved by adding electrolytes (serum-phosphate (S-P), serum-calcium (S-Ca) and serum-magnesium (S-Mg)) in a Cox regression. The study uses an 18-year follow-up of patients (n=2504) referred by physicians in primary health care and hospitals to the Vindeln Patient Education (VPE) Center, mainly with a diagnosis of hypertension (HT), type 2 diabetes mellitus (DM) and/or obesity. Cox regression, with the latest registered value and baseline values for risk factors, was used to study all-cause mortality in men and women. 221 out of 1096 men and 157 out of 1408 women died during the 18-year follow-up (20% and 11% respectively). The Cox regression analysis reveals that high blood glucose (B-Glu) and low S-Mg were significantly associated with increased all-cause mortality in the whole patient population as well as in men and women separately. Among women, type 2 DM and systolic blood pressure (SBP) and among men, high S-Ca, S-P, S-urate and body mass index (BMI) were the main predictors of all-cause mortality. There is significantly improved prediction of all-cause mortality with electrolytes added to the traditional risk factors. High B-Glu and low S-Mg in both men and women, and high S-Ca and S-P in men, are significantly associated with all-cause mortality. The metabolic disturbance in this high-risk group of patients can be more fully understood if ionic imbalance is included in the prediction of mortatlity.
authors.affiliation: Department of Family and Social Medicine, University Hospital, S-901 85, Umeå, Sweden. lena.haglin@vll.se
authors.forename: L
authors.initials: L
authors.lastname: Håglin
authors.forename: B
authors.initials: B
authors.lastname: Törnkvist
authors.forename: L
authors.initials: L
authors.lastname: Bäckman
mesh_terms: D002118:Calcium / Q000097:blood*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications* / Q000401:mortality*; D003925:Diabetic Angiopathies / Q000097:blood / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000401:mortality*; D008019:Life Style; D008274:Magnesium / Q000097:blood*; D008297:Male; D017202:Myocardial Ischemia / Q000401:mortality; D009765:Obesity / Q000097:blood / Q000401:mortality; D010710:Phosphates / Q000097:blood*; D012307:Risk Factors; D016019:Survival Analysis; D017741:Survivors
chemical_list: D010710:Phosphates; D008274:Magnesium; D002118:Calcium