Hypertension and all-cause and cause-specific mortality: An outcome-wide association study of 67 causes of death in the National Health Interview Survey.
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Author(s)
Aune, Dagfinn
Huang, Wentao
Nie, Jing
Wang, Yafeng
Type
Journal Article
Abstract
Background. Few studies have assessed the association between hypertension and risk of detailed causes of death. We investigated
the association between hypertension and all-cause mortality and 67 causes of death in a large cohort. Methods. Multivariable Cox
regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for self-reported hypertension
vs. no hypertension and mortality. Adults aged ≥18 years (n = 213798) were recruited in 1997-2004 and followed through
December 31, 2006. Results. During 5.81 years of follow-up, 11254 deaths occurred. Self-reported hypertension vs. no
hypertension was associated with increased risk of all-cause mortality (HR = 1:25, 95% CI: 1.19-1.31) and mortality from
septicemia (HR =1.66, 1.06-2.59), other infectious parasitic diseases (HR = 2:67, 1.09-6.51), diabetes mellitus (HR = 1:97, 1.45-
2.67), circulatory disease (HR = 1:49, 1.37-1.61), hypertensive heart disease (HR = 3:23, 2.00-5.20), ischemic heart disease ðHR =
1:35, 1.23-1.49), acute myocardial infarction (HR = 1:50, 1.27-1.77), other chronic ischemic heart diseases (HR = 1:35, 1.17-
1.56), all other forms of heart disease (HR = 1:51, 1.21-1.89), primary hypertension and renal disease (HR = 3:11, 1.82-5.30),
cerebrovascular disease (HR = 1:64, 1.37-1.97), other circulatory system diseases (HR = 1:71, 1.09-2.69), other chronic lower
respiratory diseases (HR = 1:39, 1.12-1.73), other chronic liver disease (HR = 1:89, 1.06-3.37), renal failure (HR = 1:91, 1.33-
2.74), motor vehicle accidents (HR = 1:60, 1.07-2.37), and all other diseases (HR =1.30, 1.10-1.54), but with lower risk of uterine
cancer (HR = 0:37, 95% CI: 0.15-0.90) and Alzheimer’s disease (HR = 0:65, 95% CI: 0.47-0.92). Conclusion. Hypertension was
associated with increased risk of all-cause mortality and 17 out of 67 causes of death, with most of these being circulatory
disease outcomes, however, some of the remaining associations are unlikely to be causal. Further studies are needed to clarify
associations with less common causes of death and potential causality across outcomes.
the association between hypertension and all-cause mortality and 67 causes of death in a large cohort. Methods. Multivariable Cox
regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for self-reported hypertension
vs. no hypertension and mortality. Adults aged ≥18 years (n = 213798) were recruited in 1997-2004 and followed through
December 31, 2006. Results. During 5.81 years of follow-up, 11254 deaths occurred. Self-reported hypertension vs. no
hypertension was associated with increased risk of all-cause mortality (HR = 1:25, 95% CI: 1.19-1.31) and mortality from
septicemia (HR =1.66, 1.06-2.59), other infectious parasitic diseases (HR = 2:67, 1.09-6.51), diabetes mellitus (HR = 1:97, 1.45-
2.67), circulatory disease (HR = 1:49, 1.37-1.61), hypertensive heart disease (HR = 3:23, 2.00-5.20), ischemic heart disease ðHR =
1:35, 1.23-1.49), acute myocardial infarction (HR = 1:50, 1.27-1.77), other chronic ischemic heart diseases (HR = 1:35, 1.17-
1.56), all other forms of heart disease (HR = 1:51, 1.21-1.89), primary hypertension and renal disease (HR = 3:11, 1.82-5.30),
cerebrovascular disease (HR = 1:64, 1.37-1.97), other circulatory system diseases (HR = 1:71, 1.09-2.69), other chronic lower
respiratory diseases (HR = 1:39, 1.12-1.73), other chronic liver disease (HR = 1:89, 1.06-3.37), renal failure (HR = 1:91, 1.33-
2.74), motor vehicle accidents (HR = 1:60, 1.07-2.37), and all other diseases (HR =1.30, 1.10-1.54), but with lower risk of uterine
cancer (HR = 0:37, 95% CI: 0.15-0.90) and Alzheimer’s disease (HR = 0:65, 95% CI: 0.47-0.92). Conclusion. Hypertension was
associated with increased risk of all-cause mortality and 17 out of 67 causes of death, with most of these being circulatory
disease outcomes, however, some of the remaining associations are unlikely to be causal. Further studies are needed to clarify
associations with less common causes of death and potential causality across outcomes.
Date Issued
2021-07-13
Date Acceptance
2021-06-28
Citation
BioMed Research International, 2021, 2021, pp.1-10
ISSN
1110-7243
Publisher
Hindawi Publishing Corporation
Start Page
1
End Page
10
Journal / Book Title
BioMed Research International
Volume
2021
Copyright Statement
© 2021 Dagfinn Aune et al. This is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
License URL
Identifier
https://www.hindawi.com/journals/bmri/2021/9376134/
Subjects
06 Biological Sciences
08 Information and Computing Sciences
10 Technology
Publication Status
Published
Date Publish Online
2021-07-13