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Incidence of myocardial infarction in elderly men being treated with antihypertensive drugs: population based cohort study

Merlo, Juan LU ; Ranstam, Jonas LU ; Liedholm, Hans LU ; Hedblad, Bo LU ; Lindberg, Gunnar LU ; Lindblad, Ulf LU ; Isacsson, Sven-Olof LU ; Melander, Arne LU and Råstam, Lennart LU (1996) In BMJ (Clinical Research Edition) 313(7055). p.457-461
Abstract
OBJECTIVE: To analyse the association between use of antihypertensive treatment, diastolic blood pressure, and long term incidence of ischaemic cardiac events in elderly men. DESIGN: Population based cohort study. Baseline examination in 1982-3 and follow up for up to 10 years. SETTING: Malmo, Sweden. SUBJECTS: 484 randomly selected men born in 1914 and living in Malmo during 1982. MAIN OUTCOME MEASURES: Observational comparisons of incidence rates and rate and hazard ratios of ischaemic cardiac events (myocardial infarction or death due to chronic ischaemic cardiac disease). RESULTS: The crude incidence rate of ischaemic cardiac events was higher in those subjects who were taking antihypertensive drugs than in those who were not (rate... (More)
OBJECTIVE: To analyse the association between use of antihypertensive treatment, diastolic blood pressure, and long term incidence of ischaemic cardiac events in elderly men. DESIGN: Population based cohort study. Baseline examination in 1982-3 and follow up for up to 10 years. SETTING: Malmo, Sweden. SUBJECTS: 484 randomly selected men born in 1914 and living in Malmo during 1982. MAIN OUTCOME MEASURES: Observational comparisons of incidence rates and rate and hazard ratios of ischaemic cardiac events (myocardial infarction or death due to chronic ischaemic cardiac disease). RESULTS: The crude incidence rate of ischaemic cardiac events was higher in those subjects who were taking antihypertensive drugs than in those who were not (rate ratio 2.6 (95% confidence interval 1.7 to 3.9)). After adjustment for potential confounders (differences in baseline smoking habits, blood pressure, time since diagnosis of hypertension, ischaemic or other cardiovascular disease, hypercholesterolaemia, hypertriglyceridaemia, diabetes mellitus, obesity, and raised serum creatinine concentration) this rate was reduced but still raised (hazard ratio 1.9 (1.0 to 3.7)). In men with diastolic blood pressure > 90 mm Hg, antihypertensive treatment was associated with a twofold increase in the incidence of ischaemic cardiac events (rate ratio 2.0 (1.1 to 3.6)), which vanished after adjustment for potential confounders (hazard ratio 1.1 (0.5 to 2.6)). In those subjects with diastolic blood pressure < or = 90 mm Hg, antihypertensive treatment was associated with fourfold increase in incidence (rate ratio 3.9 (2.1 to 7.1)), which remained after adjustment for potential confounders (hazard ratio 3.8 (1.3 to 11.0)). CONCLUSION: Antihypertensive treatment may increase the risk of myocardial infarction in elderly men with treated diastolic blood pressures < or = 90 mm Hg. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMJ (Clinical Research Edition)
volume
313
issue
7055
pages
457 - 461
publisher
British Medical Association
external identifiers
  • pmid:8776312
  • scopus:0029777482
ISSN
0959-8138
language
English
LU publication?
yes
id
2a33c191-0bf0-4f55-8bf7-74ba600e687e (old id 1110876)
alternative location
http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=2351832&blobtype=pdf
date added to LUP
2008-07-28 08:52:41
date last changed
2017-08-06 04:41:26
@article{2a33c191-0bf0-4f55-8bf7-74ba600e687e,
  abstract     = {OBJECTIVE: To analyse the association between use of antihypertensive treatment, diastolic blood pressure, and long term incidence of ischaemic cardiac events in elderly men. DESIGN: Population based cohort study. Baseline examination in 1982-3 and follow up for up to 10 years. SETTING: Malmo, Sweden. SUBJECTS: 484 randomly selected men born in 1914 and living in Malmo during 1982. MAIN OUTCOME MEASURES: Observational comparisons of incidence rates and rate and hazard ratios of ischaemic cardiac events (myocardial infarction or death due to chronic ischaemic cardiac disease). RESULTS: The crude incidence rate of ischaemic cardiac events was higher in those subjects who were taking antihypertensive drugs than in those who were not (rate ratio 2.6 (95% confidence interval 1.7 to 3.9)). After adjustment for potential confounders (differences in baseline smoking habits, blood pressure, time since diagnosis of hypertension, ischaemic or other cardiovascular disease, hypercholesterolaemia, hypertriglyceridaemia, diabetes mellitus, obesity, and raised serum creatinine concentration) this rate was reduced but still raised (hazard ratio 1.9 (1.0 to 3.7)). In men with diastolic blood pressure &gt; 90 mm Hg, antihypertensive treatment was associated with a twofold increase in the incidence of ischaemic cardiac events (rate ratio 2.0 (1.1 to 3.6)), which vanished after adjustment for potential confounders (hazard ratio 1.1 (0.5 to 2.6)). In those subjects with diastolic blood pressure &lt; or = 90 mm Hg, antihypertensive treatment was associated with fourfold increase in incidence (rate ratio 3.9 (2.1 to 7.1)), which remained after adjustment for potential confounders (hazard ratio 3.8 (1.3 to 11.0)). CONCLUSION: Antihypertensive treatment may increase the risk of myocardial infarction in elderly men with treated diastolic blood pressures &lt; or = 90 mm Hg.},
  author       = {Merlo, Juan and Ranstam, Jonas and Liedholm, Hans and Hedblad, Bo and Lindberg, Gunnar and Lindblad, Ulf and Isacsson, Sven-Olof and Melander, Arne and Råstam, Lennart},
  issn         = {0959-8138},
  language     = {eng},
  number       = {7055},
  pages        = {457--461},
  publisher    = {British Medical Association},
  series       = {BMJ (Clinical Research Edition)},
  title        = {Incidence of myocardial infarction in elderly men being treated with antihypertensive drugs: population based cohort study},
  volume       = {313},
  year         = {1996},
}