reports

Mortalidad por cualquier causa e incidencia de enfermedad cardiovascular en hipertensos con perfil tipo Anglo-Scandinavian Cardiac Outcomes Trial en un ambito poblacional espanol

Aten Primaria 42:420-430. Published in Spanish.

Dirección de Planificación, Badalona Serveis Assistencials S.A., Badalona, Barcelona, Spain

OBJECTIVES: Mediterranean populations are traditionally considered to be associated with lower incidence of cardiovascular events (CVE). However, this might not be homogeneous throughout different patient strata. The goal was to compare the incidence of CVE and all-causes mortality in hypertensive patients with an ASCOT-type profile with that of the rest hypertensive subjects.

METHODS: A retrospective analysis was carried out using a claim database. Hypertensive patients without known cardiovascular disease on antihypertensive therapy included during year 2006 were followed up for two consecutive years to ascertain the incidence of all-causes mortality and any CVE. CVE included any of the following: coronary heart disease, acute myocardial infarction (AMI), angina, stroke, transient ischemic attack (TIA) and peripheral artery disease. Patients with ASCOT and ASCOT-LLA type profiles were identified and compared with non-ASCOT-type profile hypertensive subjects.

RESULTS: A total of 11,104 were included in the analysis; 68.0711.4 years, 41.6% males. More than 73% of subjects fulfilled criteria for ASCOT-type profile. All-causes mortality were numerically higher in ASCOT and ASCOT-LLA subjects compared with non-ASCOTtype; hazard ratio (95% CI) ¼ 1.3 (0.8 – 1.9) and 1.6 (0.9 – 2.8), respectively. However, anycoronary event rate was significantly higher in ASCOT-type [2.3 (1.8 – 2.8), po0.001], as well as in ASCOT-LLA subjects [1.8 (1.3 – 2.4), po0.001].

CONCLUSIONS: Hypertensive patients on treatment with ASCOT-type profile are more likely to have any cardiovascular event than those hypertensive patients without ASCOT profile in a Mediterranean setting in Spain.