title: Predictors of acute myocardial infarction mortality in hypertensive patients treated in primary care: a population-based follow-up study in the Skaraborg Project.
abstract: OBJECTIVE
  To explore risk factors for acute myocardial infarction (AMI) mortality in hypertensive patients treated in primary care.
  
  
  METHODS
  Community-based cohort study.
  
  
  METHODS
  Hypertension outpatient clinic in primary health care.
  
  
  METHODS
  Patients who consecutively underwent an annual follow-up during 1992-1993 (n =894; 377 men and 517 women).
  
  
  METHODS
  All events of fatal AMI were ascertained by record linkage to the National Mortality Register to December 31, 2002. Gender-specific predictors for AMI mortality were analysed by Cox regression.
  
  
  METHODS
  AMI mortality.
  
  
  RESULTS
  During a mean follow-up of 8.7 years 32 cases (8.5%) of fatal AMI were observed in men and 31 cases (6.0%) were observed in women. Most important predictors for AMI mortality in men were microalbuminuria (HR 3.8, CI 1.8-8.0) and left ventricular hypertrophy (HR 4.0, CI 1.7-9.4), whilst in women type 2 diabetes (HR 4.8, CI 2.4-9.8) was an important predictor. In hypertensive patients without diabetes male gender was associated with high AMI mortality (HR 2.7, CI 1.4-5.3), but in patients with both hypertension and type 2 diabetes the higher risk in men disappeared (HR 0.8, CI 0.4-1.7).
  
  
  CONCLUSIONS
  Cardiovascular disease risk factors remain strong predictors of AMI mortality in hypertensive patients but with a different pattern in the two genders. Markers of organ damage are more important predictors in men, whereas markers of impaired glucose metabolism are more important predictors in women.
authors.affiliation: University of Lund, Department of Clinical Sciences, Malmö University Hospital, Malmö, Sweden. erik.bog-hansen@vgregion.se
authors.forename: Erik
authors.initials: E
authors.lastname: Bøg-Hansen
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Larsson
authors.forename: Bo
authors.initials: B
authors.lastname: Gullberg
authors.forename: Arne
authors.initials: A
authors.lastname: Melander
authors.forename: Kristina
authors.initials: K
authors.lastname: Boström
authors.forename: Lennart
authors.initials: L
authors.lastname: Råstam
authors.forename: Ulf
authors.initials: U
authors.lastname: Lindblad
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000150:complications; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality*; D011320:Primary Health Care; D011379:Prognosis; D012307:Risk Factors; D012737:Sex Factors; D013548:Sweden / Q000453:epidemiology