Profiles of mortality among Chinese hypertensive patients in Hong Kong: a cohort study

Jiang, J.Y., Wong, M.C.S., Zhang, X.H., Fung, H., Griffiths, S. and Mercer, S.W. (2009) Profiles of mortality among Chinese hypertensive patients in Hong Kong: a cohort study. Journal of Human Hypertension, 23(11), pp. 735-742. (doi:10.1038/jhh.2009.22)

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Publisher's URL: http://dx.doi.org/10.1038/jhh.2009.22

Abstract

We studied the profiles of all-cause and cardiovascular (CVS) mortality among users of different antihypertensive classes in a Chinese population. From electronic patient records, a cohort study was conducted among 18,338 patients who ever newly prescribed an alpha-blocker, thiazide diuretic, beta-blocker, calcium channel blocker (CCB) or agents acting on the renin-angiotensin system (RAS) without drug discontinuation or switching in the public primary-care sector in a large Territory of Hong Kong during January 2004-June 2007. The odds ratios of mortality (all-cause and CVS) were evaluated according to the prescribed antihypertensive drug classes by Cox proportional hazards regression analyses. A total of 823 deaths (4.5%) were reported during the study period. The crude proportions of all-cause mortality were highest in alpha-blockers (6.2%) and CCB (5.7%), but lowest in beta-blockers (2.8%). Compared with CCB, patients on thiazide diuretics were shown to have statistically significantly lower all-cause (adjusted hazard ratios (aHRs) 0.75, 95% CI 0.60, 0.93, P=0.010) and CVS mortality (aHR 0.40, 95% CI 0.21, 0.78, P=0.007), but the 95% CI of the odds ratios of the major drug classes overlapped. When each drug class was used as a reference group, or when patients with only uncomplicated hypertension were included, their respective 95% CI similarly overlapped. Antihypertensive drug classes were associated with statistically comparable odds of all-cause and CVS mortality. This finding from real-life clinical practice further supports the position statements from international guidelines, which recommend that the major antihypertensive drug classes are suitable for initiating pharmacotherapy for the management of hypertension.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Mercer, Professor Stewart
Authors: Jiang, J.Y., Wong, M.C.S., Zhang, X.H., Fung, H., Griffiths, S., and Mercer, S.W.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:Journal of Human Hypertension

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