ASSOCIATIONS OF ISCHEMIC HEART DISEASE AND ARTERIAL HYPERTENSION, AND THEIR IMPORTANCE FOR MORTALITY FROM CARDIOVASCULAR CAUSES AND ALL CAUSES, OF PEOPLE AGED MORE THAN 55 YEARS OLD

Abstract

Aim. To study the associations between ischemic heart disease (IHD) and arterial hypertension (AH) in population of men and women 55 years old and more and to estimate the impact to mortality from cardiovascular diseases (CVD) and all causes.Material and methods. The results obtained under the circumstances of prospective study that included 1871 persons (response was 64%), Moscow citizens, with the age 55 y. and older, participants of the cohort study “Stress, ageing and health”. During the study the demographic data was collected, anthropometric parameters and resting ECG, blood pressure (BP). Epidemiologic diagnosis of IHD was set with the Rose Questionnaire and ECG parameters, coded by Minnesota code (MC). Mean time of observation was 4,7 years. Totally 332 lethal cases registered, including 197 — from CVD. Statistical analysis was done with SAS software.Results. During the analysis we found highly significant positive correlations of prevalence of raised (≥140/90 mmHg) and high (160/95 mmHg) BP, prevalence of AH with IHD of various severity that increase with the age, do not depend on education level and are more prominent in men. In monofactorial regression analysis, by correction for age and sex, the significant relation is found only for mortality from all causes only with definite IHD (dIHD) (OR 1,86; 95% CI 1,42-2,46, р=0,0001), though in probable IHD there is no such relation (OR 1,20; 95% CI 0,91- 1,58, р=0,194); there were much less prominent associations with mortality of the raised and high BPs (OR 1,33; 95% CI 1,04-1,63) and (OR 1,33; 95% CI 1,06-1,67), respectively, and hypertension did not influence mortality on its own (OR 1,13; 95% CI 0,87-1,48, р=0,36). Same associations were found for the mortality from CVD. In combined analysis of mortality and dIHD together with different BP levels there was highly significant increase of mortality from all causes in IHD patients, and impact of high BP is much weaker. With the mortality from CVD there is only association of dIHD and high BP, but raised BP losses its own significance.Conclusion. At the age 55 y. and older, AH is definitely associated with IHD, increasing the prevalence from 65% in non-IHD to 81% in dIHD. However, while corrected by sex and age, only presence of IHD strictly and significantly increases the risk of CV death and from all causes, while among various BP levels just the high level positively associates with all-causes mortality.

Keywords

• ischemic heart disease
• arterial hypertension
• all-causes mortality
• cv mortality