(Hypertension. 2001;37:1256.)
© 2001 American Heart Association, Inc.
Scientific Contributions |
Cardiovascular Mortality in Hypertensive Men According to Presence of Associated Risk Factors
From the Centre d’Investigations Préventives et Cliniques, Paris, France.
Correspondence to Athanase Benetos, MD, PhD, Centre IPC, 6/14 rue La Pérouse, 75784 Paris Cedex 16, France. E-mail benetos{at}ipc.asso.fr
Abstract—To
evaluate the risk of cardiovascular disease (CVD)
mortality in hypertensive men according to the presence of associated
risk factors (ARFs). The population was composed of 29 640
normotensive men without ARFs (reference group) and 60 343
hypertensive men (with and without ARFs) who had a standard health
checkup at the Centre d’Investigations Préventives et Cliniques
between 1978 and 1988. Mortality data for a mean period of 14 years
were analyzed. The following ARFs were considered: total
cholesterol 
2.5 g/L, personal history of diabetes,
smoking (current smokers), body mass index >28
kg/m2, and heart rate >80 bpm. CVD risk
related to the presence of isolated hypertension (assessed in
hypertensive subjects without ARFs versus the reference group)
increased linearly from 15% at the age of 30 years to 134% at the age
of 80 years. In hypertensive subjects, one additional ARF increased CVD
risk by 56% (47% to 65%,
P<0.01) in younger subjects
but only by 4% (-8% to 17%,
P=NS) in older subjects. The
role of hypercholesterolemia and tobacco
smoking in CVD mortality was significantly higher in hypertensive
subjects aged <55 years than in hypertensive subjects aged 55 years
(P<0.01), whereas the roles of
tachycardia and obesity were not affected by age. In
younger hypertensive subjects, evaluation of CVD risk and therapeutic
strategies should target ARFs. In older subjects, the presence of high
blood pressure levels seems to be the major determinant of CVD
risk.
Key Words: hypertension, essential • risk factors • blood pressure • mortality
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