Cardiovascular and total mortality in men and women with different blood pressure levels - A 26-year follow-up

Aim. Our aim was to study different levels of high blood pressure and normal blood pressure (reference) to calculate the hazard ratios (HRs) for cardiovascular and total mortality in men and women with adjustments for many covariates. Methods. A health-screening program was offered to a population-based sample in Stockholm County to estimate healthcare needs (a proxy for co-morbidity). Blood pressure measurements (mmHg systolic/diastolic) were available for 2280 participants (74%). Mortality was followed up for 26 years. Results. HRs with confidence intervals (CI) were calculated. The HR for all-cause mortality in those with very high blood pressure, >= 160and/or 95, was 1.93 (1.38-2.70) in men and 2.29 (1.42-3.69) in women. High blood pressure (>= 140 and/or 90 but <160 and 95 cmHg) and prehypertension (>= 130 and/or 85 but <140 and 90) were significant in women but not in men. Diagnosed hypertension with antihypertensive treatment adjusted for blood pressure level was non-significant in all models. Conclusion. Very high blood pressure was an independent risk factor for both total and cardiovascular mortality in both men and women after adjustments for all covariates including healthcare need. Hypertension seems just as important to treat in individuals with co-morbidities.