Predictors of acute myocardial infarction mortality in hypertensive patients treated in primary care: a population-based follow-up study in the Skaraborg Project.
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.
Bøg-Hansen
Erik
E
University of Lund, Department of Clinical Sciences, Malmö University Hospital, Malmö, Sweden. erik.bog-hansen@vgregion.se
Larsson
Charlotte A
CA
Gullberg
Bo
B
Melander
Arne
A
Boström
Kristina
K
Råstam
Lennart
L
Lindblad
Ulf
U
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