title: Incidence, cardiovascular complications and mortality of hypertension by sex and ethnicity.
abstract: OBJECTIVE
  To compare ethnic and sex difference in the incidence of newly diagnosed hypertension, and subsequent risk of cardiovascular disease outcomes among South Asian, Chinese and white patients.
  
  
  METHODS
  We identified patients with newly diagnosed hypertension aged ≥20 years. Patients were followed for 1-9 years for all-cause mortality and cardiovascular disease with myocardial infarction, heart failure and stroke. Cox proportional hazard models stratified by sex and adjusted for age, median income and co-morbid conditions, were constructed to determine the independent association between ethnicity and the development of the combined cardiovascular endpoint as well as death.
  
  
  RESULTS
  There were 39 175 South Asian (49.4% men, 34.4% age ≥65), 49 892 Chinese (48.1% men, 36.7% age ≥65) and 841 277 white (47.9% men, 38.8% age ≥65) patients with newly diagnosed hypertension. Age and sex adjusted incidence of hypertension was highest in South Asian patients and lowest in Chinese patients. Compared with white patients, South Asian and Chinese patients had a lower mortality (adjusted HR (aHR) 0.91 and 0.66) and risk of cardiovascular disease outcomes (aHR 0.94 and 0.49). Compared to men, women had significantly lower mortality (aHR: 0.83 for Chinese, 0.78 for South Asian and 0.77 for white) and cardiovascular disease outcomes (0.72 for Chinese, 0.63 for South Asian and 0.65 for white).
  
  
  CONCLUSIONS
  South Asian patients had higher rates of hypertension compared to the other ethnic groups. South Asian and Chinese patients had a lower risk of death and developing cardiovascular outcomes compared to whites. Women with hypertension have a better prognosis than men regardless of ethnicity.
authors: Department of Community Health Sciences, University of Calgary, 3280 Hospital Dr NW, Calgary, Alberta, Canada T2N 4Z6. hquan@ucalgary.ca
authors: Hude
authors: H
authors: Quan
authors: Guanmin
authors: G
authors: Chen
authors: Robin L
authors: RL
authors: Walker
authors: Andy
authors: A
authors: Wielgosz
authors: Sulan
authors: S
authors: Dai
authors: Karen
authors: K
authors: Tu
authors: Norm R C
authors: NR
authors: Campbell
authors: Brenda R
authors: BR
authors: Hemmelgarn
authors: Michael D
authors: MD
authors: Hill
authors: Helen
authors: H
authors: Johansen
authors: Finlay A
authors: FA
authors: McAlister
authors: Nadia
authors: N
authors: Khan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006333:Heart Failure / Q000208:ethnology* / Q000209:etiology / Q000401:mortality; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000208:ethnology* / Q000401:mortality; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000208:ethnology* / Q000209:etiology / Q000401:mortality; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D017678:Sex Distribution; D012737:Sex Factors; D020521:Stroke / Q000208:ethnology* / Q000209:etiology / Q000401:mortality; D015996:Survival Rate / Q000639:trends; D055815:Young Adult