HYPERTENSION AND BORDERLINE ISOLATED SYSTOLIC HYPERTENSION INCREASE RISKS OF CARDIOVASCULAR-DISEASE AND MORTALITY IN MALE PHYSICIANS

Background The objective of this study was to examine whether definite hypertension and borderline isolated systolic hypertension predict su bsequent cardiovascular disease and mortality. Methods and Results Thi s was a prospective cohort study with a mean follow-up of 11.7 years. The subjects were a group of 18 682 apparently healthy US men, aged 40 to 84 years, participating in the Physicians' Health Study, a randomi zed trial of low-dose aspirin and beta-carotene. The main outcome meas ures were total cardiovascular disease, myocardial infarction, stroke, cardiovascular death, and all-cause mortality. Hypertension was assoc iated with substantially increased risks of total cardiovascular disea se (relative risk [RR] 1.92; 95% confidence interval [CI], 1.70 to 2.1 8), myocardial infarction (RR, 1.78; 95% CI: 1.49 to 2.13), stroke (RR , 2.19; 95% CI, 1.78 to 2.69), and cardiovascular death (RR, 2.10; 95% CI, 1.68 to 2.63). Borderline isolated systolic hypertension was asso ciated with significantly increased risks of cardiovascular disease (R R, 1.32; 95% CI, 1.09 to 1.59), stroke (RR, 1.42; 95% CI, 1.04 to 1.93 ), and cardiovascular death (RR, 1.56; 95% CI, 1.13 to 2.15), as well as a possible but non significant increased risk of myocardial infarct ion (RR, 1.26; 95% CI. 0.95 to 1.67). Hypertension and borderline isol ated systolic hypertension were associated with significantly increase d risks of 41% and 22%, respectively, for all-cause mortality. Conclus ions Hypertension as well as borderline isolated systolic hypertension are associated with elevated risks of cardiovascular diseases, especi ally stroke and cardiovascular death. Hypertension is associated with an increased risk of myocardial infarction, and borderline isolated sy stolic hypertension predicts a possible but more modest increase in ri sk. These data add to the existing evidence that hypertension is a maj or cardiovascular risk factor and extend the findings to borderline is olated systolic hypertension.