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Hematocrit Predicts Long-Term Mortality in a Nonlinear and Sex-Specific Manner in Hypertensive Adults

Hematocrit has been inconsistently reported to be a risk marker of cardiovascular morbidity and mortality. The Glasgow Blood Pressure Clinic Study cohort included 10951 hypertensive patients, who had hematocrit measured at their initial clinic visit and followed for ≤35 years. Cox proportional hazar... Full description

Journal Title: Hypertension (Dallas Tex. 1979), 2012-09, Vol.60 (3), p.631-638
Main Author: Paul, Laura
Other Authors: Jeemon, Panniyammakal , Hewitt, Jonathan , McCallum, Linsay , Higgins, Peter , Walters, Matthew , McClure, John , Dawson, Jesse , Meredith, Peter , Jones, Gregory C , Muir, Scott , Dominiczak, Anna F , Lowe, Gordon , McInnes, Gordon T , Padmanabhan, Sandosh
Format: Electronic Article Electronic Article
Language: English
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Publisher: Hagerstown, MD: American Heart Association, Inc
ID: ISSN: 0194-911X
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title: Hematocrit Predicts Long-Term Mortality in a Nonlinear and Sex-Specific Manner in Hypertensive Adults
format: Article
creator:
  • Paul, Laura
  • Jeemon, Panniyammakal
  • Hewitt, Jonathan
  • McCallum, Linsay
  • Higgins, Peter
  • Walters, Matthew
  • McClure, John
  • Dawson, Jesse
  • Meredith, Peter
  • Jones, Gregory C
  • Muir, Scott
  • Dominiczak, Anna F
  • Lowe, Gordon
  • McInnes, Gordon T
  • Padmanabhan, Sandosh
subjects:
  • Adult
  • Aged
  • Arterial hypertension. Arterial hypotension
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Blood Pressure - physiology
  • Cardiology. Vascular system
  • Cardiovascular Diseases - etiology
  • Cardiovascular Diseases - mortality
  • Cardiovascular Diseases - physiopathology
  • Cohort Studies
  • Experimental diseases
  • Female
  • Follow-Up Studies
  • Hematocrit
  • Humans
  • Hypertension - complications
  • Hypertension - mortality
  • Hypertension - physiopathology
  • Kaplan-Meier Estimate
  • Longitudinal Studies
  • Male
  • Medical sciences
  • Middle Aged
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Risk Factors
  • Sex Characteristics
ispartof: Hypertension (Dallas, Tex. 1979), 2012-09, Vol.60 (3), p.631-638
description: Hematocrit has been inconsistently reported to be a risk marker of cardiovascular morbidity and mortality. The Glasgow Blood Pressure Clinic Study cohort included 10951 hypertensive patients, who had hematocrit measured at their initial clinic visit and followed for ≤35 years. Cox proportional hazards models were used to estimate hazard ratios for all-cause, cardiovascular, ischemic heart disease, stroke, and noncardiovascular mortality. There were 3484 deaths over a follow-up period of 173245 person-years. Hematocrit was higher in men (median, 0.44; interquartile range, 0.42–0.47) than in women (median, 0.41; interquartile range, 0.38–0.43). The lowest risk for all-cause mortality was seen in quartile 2 for men (range, 0.421–0.440) and women (range, 0.381–0.400). Compared with quartile 2, the adjusted hazard ratios for quartiles 1, 3, and 4 were, respectively, 1.11 (range, 0.97–1.28), 1.19 (range, 1.04–1.37), and 1.22 (range, 1.06–1.39) in men and 1.17 (range, 1.01–1.36), 0.97 (range, 0.83–1.13), and 1.19 (range, 1.04–1.37) in women. Men showed a J-shaped pattern for cardiovascular mortality and a linear pattern for noncardiovascular mortality in cause-specific analysis, whereas in women a U-shaped pattern was observed for noncardiovascular mortality only. Higher baseline hematocrit was associated with higher on-treatment blood pressure during follow-up. Baseline hematocrit did not affect the time to reach target blood pressure. The increased risk of death attributed to higher hematocrit was seen in men and women irrespective of their achievement of target blood pressure, indicating that the risk is independent of the effect of hematocrit on blood pressure. Hypertensive patients with hematocrit levels outside of the sex-specific reference ranges identified in this study should be targeted for more aggressive blood pressure and cardiovascular risk reduction treatment.
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleHematocrit Predicts Long-Term Mortality in a Nonlinear and Sex-Specific Manner in Hypertensive Adults
creatorPaul, Laura ; Jeemon, Panniyammakal ; Hewitt, Jonathan ; McCallum, Linsay ; Higgins, Peter ; Walters, Matthew ; McClure, John ; Dawson, Jesse ; Meredith, Peter ; Jones, Gregory C ; Muir, Scott ; Dominiczak, Anna F ; Lowe, Gordon ; McInnes, Gordon T ; Padmanabhan, Sandosh
creatorcontribPaul, Laura ; Jeemon, Panniyammakal ; Hewitt, Jonathan ; McCallum, Linsay ; Higgins, Peter ; Walters, Matthew ; McClure, John ; Dawson, Jesse ; Meredith, Peter ; Jones, Gregory C ; Muir, Scott ; Dominiczak, Anna F ; Lowe, Gordon ; McInnes, Gordon T ; Padmanabhan, Sandosh
descriptionHematocrit has been inconsistently reported to be a risk marker of cardiovascular morbidity and mortality. The Glasgow Blood Pressure Clinic Study cohort included 10951 hypertensive patients, who had hematocrit measured at their initial clinic visit and followed for ≤35 years. Cox proportional hazards models were used to estimate hazard ratios for all-cause, cardiovascular, ischemic heart disease, stroke, and noncardiovascular mortality. There were 3484 deaths over a follow-up period of 173245 person-years. Hematocrit was higher in men (median, 0.44; interquartile range, 0.42–0.47) than in women (median, 0.41; interquartile range, 0.38–0.43). The lowest risk for all-cause mortality was seen in quartile 2 for men (range, 0.421–0.440) and women (range, 0.381–0.400). Compared with quartile 2, the adjusted hazard ratios for quartiles 1, 3, and 4 were, respectively, 1.11 (range, 0.97–1.28), 1.19 (range, 1.04–1.37), and 1.22 (range, 1.06–1.39) in men and 1.17 (range, 1.01–1.36), 0.97 (range, 0.83–1.13), and 1.19 (range, 1.04–1.37) in women. Men showed a J-shaped pattern for cardiovascular mortality and a linear pattern for noncardiovascular mortality in cause-specific analysis, whereas in women a U-shaped pattern was observed for noncardiovascular mortality only. Higher baseline hematocrit was associated with higher on-treatment blood pressure during follow-up. Baseline hematocrit did not affect the time to reach target blood pressure. The increased risk of death attributed to higher hematocrit was seen in men and women irrespective of their achievement of target blood pressure, indicating that the risk is independent of the effect of hematocrit on blood pressure. Hypertensive patients with hematocrit levels outside of the sex-specific reference ranges identified in this study should be targeted for more aggressive blood pressure and cardiovascular risk reduction treatment.
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subjectAdult ; Aged ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Pressure - physiology ; Cardiology. Vascular system ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - mortality ; Cardiovascular Diseases - physiopathology ; Cohort Studies ; Experimental diseases ; Female ; Follow-Up Studies ; Hematocrit ; Humans ; Hypertension - complications ; Hypertension - mortality ; Hypertension - physiopathology ; Kaplan-Meier Estimate ; Longitudinal Studies ; Male ; Medical sciences ; Middle Aged ; Predictive Value of Tests ; Proportional Hazards Models ; Risk Factors ; Sex Characteristics
ispartofHypertension (Dallas, Tex. 1979), 2012-09, Vol.60 (3), p.631-638
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8Meredith, Peter
9Jones, Gregory C
10Muir, Scott
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12Lowe, Gordon
13McInnes, Gordon T
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descriptionHematocrit has been inconsistently reported to be a risk marker of cardiovascular morbidity and mortality. The Glasgow Blood Pressure Clinic Study cohort included 10951 hypertensive patients, who had hematocrit measured at their initial clinic visit and followed for ≤35 years. Cox proportional hazards models were used to estimate hazard ratios for all-cause, cardiovascular, ischemic heart disease, stroke, and noncardiovascular mortality. There were 3484 deaths over a follow-up period of 173245 person-years. Hematocrit was higher in men (median, 0.44; interquartile range, 0.42–0.47) than in women (median, 0.41; interquartile range, 0.38–0.43). The lowest risk for all-cause mortality was seen in quartile 2 for men (range, 0.421–0.440) and women (range, 0.381–0.400). Compared with quartile 2, the adjusted hazard ratios for quartiles 1, 3, and 4 were, respectively, 1.11 (range, 0.97–1.28), 1.19 (range, 1.04–1.37), and 1.22 (range, 1.06–1.39) in men and 1.17 (range, 1.01–1.36), 0.97 (range, 0.83–1.13), and 1.19 (range, 1.04–1.37) in women. Men showed a J-shaped pattern for cardiovascular mortality and a linear pattern for noncardiovascular mortality in cause-specific analysis, whereas in women a U-shaped pattern was observed for noncardiovascular mortality only. Higher baseline hematocrit was associated with higher on-treatment blood pressure during follow-up. Baseline hematocrit did not affect the time to reach target blood pressure. The increased risk of death attributed to higher hematocrit was seen in men and women irrespective of their achievement of target blood pressure, indicating that the risk is independent of the effect of hematocrit on blood pressure. Hypertensive patients with hematocrit levels outside of the sex-specific reference ranges identified in this study should be targeted for more aggressive blood pressure and cardiovascular risk reduction treatment.
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20Longitudinal Studies
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26Risk Factors
27Sex Characteristics
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titleHematocrit Predicts Long-Term Mortality in a Nonlinear and Sex-Specific Manner in Hypertensive Adults
authorPaul, Laura ; Jeemon, Panniyammakal ; Hewitt, Jonathan ; McCallum, Linsay ; Higgins, Peter ; Walters, Matthew ; McClure, John ; Dawson, Jesse ; Meredith, Peter ; Jones, Gregory C ; Muir, Scott ; Dominiczak, Anna F ; Lowe, Gordon ; McInnes, Gordon T ; Padmanabhan, Sandosh
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7Cardiovascular Diseases - etiology
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25Proportional Hazards Models
26Risk Factors
27Sex Characteristics
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abstractHematocrit has been inconsistently reported to be a risk marker of cardiovascular morbidity and mortality. The Glasgow Blood Pressure Clinic Study cohort included 10951 hypertensive patients, who had hematocrit measured at their initial clinic visit and followed for ≤35 years. Cox proportional hazards models were used to estimate hazard ratios for all-cause, cardiovascular, ischemic heart disease, stroke, and noncardiovascular mortality. There were 3484 deaths over a follow-up period of 173245 person-years. Hematocrit was higher in men (median, 0.44; interquartile range, 0.42–0.47) than in women (median, 0.41; interquartile range, 0.38–0.43). The lowest risk for all-cause mortality was seen in quartile 2 for men (range, 0.421–0.440) and women (range, 0.381–0.400). Compared with quartile 2, the adjusted hazard ratios for quartiles 1, 3, and 4 were, respectively, 1.11 (range, 0.97–1.28), 1.19 (range, 1.04–1.37), and 1.22 (range, 1.06–1.39) in men and 1.17 (range, 1.01–1.36), 0.97 (range, 0.83–1.13), and 1.19 (range, 1.04–1.37) in women. Men showed a J-shaped pattern for cardiovascular mortality and a linear pattern for noncardiovascular mortality in cause-specific analysis, whereas in women a U-shaped pattern was observed for noncardiovascular mortality only. Higher baseline hematocrit was associated with higher on-treatment blood pressure during follow-up. Baseline hematocrit did not affect the time to reach target blood pressure. The increased risk of death attributed to higher hematocrit was seen in men and women irrespective of their achievement of target blood pressure, indicating that the risk is independent of the effect of hematocrit on blood pressure. Hypertensive patients with hematocrit levels outside of the sex-specific reference ranges identified in this study should be targeted for more aggressive blood pressure and cardiovascular risk reduction treatment.
copHagerstown, MD
pubAmerican Heart Association, Inc
pmid22802225
doi10.1161/HYPERTENSIONAHA.112.191510
oafree_for_read