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The impact of diabetes, education and income on mortality and cardiovascular events in hypertensive patients : A cohort study from the Swedish Primary Care Cardiovascular Database (SPCCD)

Andersson, Tobias ; Pikkemaat, Miriam LU orcid ; Schio, Linus ¨ler ; Hjerpe, Per LU ; Carlsso, Axel C. ; Wändell, Per LU ; Manhem, Karin ; Kahan, Thomas ; Hasselstrom, Jan and Bostrom, Kristina Bengtsson (2020) In PLoS ONE 15(8 August).
Abstract

Objective In this study we aimed to estimate the effect of diabetes, educational level and income on the risk of mortality and cardiovascular events in primary care patients with hypertension. Methods We followed 62,557 individuals with hypertension diagnosed 2001-2008, in the Swedish Primary Care Cardiovascular Database. Study outcomes were death, myocardial infarction, and ischemic stroke, assessed using national registers until 2012. Cox regression models were used to estimate adjusted hazard ratios of outcomes according to diabetes status, educational level, and income. Results During follow-up, 13,231 individuals died, 9981 were diagnosed with diabetes, 4431 with myocardial infarction, and 4433 with ischemic stroke. Hazard ratios... (More)

Objective In this study we aimed to estimate the effect of diabetes, educational level and income on the risk of mortality and cardiovascular events in primary care patients with hypertension. Methods We followed 62,557 individuals with hypertension diagnosed 2001-2008, in the Swedish Primary Care Cardiovascular Database. Study outcomes were death, myocardial infarction, and ischemic stroke, assessed using national registers until 2012. Cox regression models were used to estimate adjusted hazard ratios of outcomes according to diabetes status, educational level, and income. Results During follow-up, 13,231 individuals died, 9981 were diagnosed with diabetes, 4431 with myocardial infarction, and 4433 with ischemic stroke. Hazard ratios (95% confidence intervals) for diabetes versus no diabetes: mortality 1.57 (1.50-1.65), myocardial infarction 1.24 (1.14-1.34), and ischemic stroke 1.17 (1.07-1.27). Hazard ratios for diabetes and ≤9 years of school versus no diabetes and >12 years of school: mortality 1.56 (1.41-1.73), myocardial infarction 1.36 (1.17-1.59), and ischemic stroke 1.27 (1.08-1.50). Hazard ratios for diabetes and income in the lowest fifth group versus no diabetes and income in the highest fifth group: mortality 3.82 (3.36-4.34), myocardial infarction 2.00 (1.66-2.42), and ischemic stroke 1.91 (1.58-2.31). Conclusions Diabetes combined with low income was associated with substantial excess risk of mortality, myocardial infarction and ischemic stroke among primary care patients with hypertension.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
15
issue
8 August
article number
e0237107
publisher
Public Library of Science (PLoS)
external identifiers
  • scopus:85089043898
  • pmid:32745121
ISSN
1932-6203
DOI
10.1371/journal.pone.0237107
language
English
LU publication?
yes
id
1d5f58b4-216f-4dfb-947a-461e83ebd2eb
date added to LUP
2021-01-12 08:46:44
date last changed
2024-04-17 23:34:20
@article{1d5f58b4-216f-4dfb-947a-461e83ebd2eb,
  abstract     = {{<p>Objective In this study we aimed to estimate the effect of diabetes, educational level and income on the risk of mortality and cardiovascular events in primary care patients with hypertension. Methods We followed 62,557 individuals with hypertension diagnosed 2001-2008, in the Swedish Primary Care Cardiovascular Database. Study outcomes were death, myocardial infarction, and ischemic stroke, assessed using national registers until 2012. Cox regression models were used to estimate adjusted hazard ratios of outcomes according to diabetes status, educational level, and income. Results During follow-up, 13,231 individuals died, 9981 were diagnosed with diabetes, 4431 with myocardial infarction, and 4433 with ischemic stroke. Hazard ratios (95% confidence intervals) for diabetes versus no diabetes: mortality 1.57 (1.50-1.65), myocardial infarction 1.24 (1.14-1.34), and ischemic stroke 1.17 (1.07-1.27). Hazard ratios for diabetes and ≤9 years of school versus no diabetes and &gt;12 years of school: mortality 1.56 (1.41-1.73), myocardial infarction 1.36 (1.17-1.59), and ischemic stroke 1.27 (1.08-1.50). Hazard ratios for diabetes and income in the lowest fifth group versus no diabetes and income in the highest fifth group: mortality 3.82 (3.36-4.34), myocardial infarction 2.00 (1.66-2.42), and ischemic stroke 1.91 (1.58-2.31). Conclusions Diabetes combined with low income was associated with substantial excess risk of mortality, myocardial infarction and ischemic stroke among primary care patients with hypertension.</p>}},
  author       = {{Andersson, Tobias and Pikkemaat, Miriam and Schio, Linus ¨ler and Hjerpe, Per and Carlsso, Axel C. and Wändell, Per and Manhem, Karin and Kahan, Thomas and Hasselstrom, Jan and Bostrom, Kristina Bengtsson}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{8 August}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{The impact of diabetes, education and income on mortality and cardiovascular events in hypertensive patients : A cohort study from the Swedish Primary Care Cardiovascular Database (SPCCD)}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0237107}},
  doi          = {{10.1371/journal.pone.0237107}},
  volume       = {{15}},
  year         = {{2020}},
}