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Treatment of hypert...
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Bager, Johan-EmilGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
(author)
Treatment of hypertension in old patients without previous cardiovascular disease.
- Article/chapterEnglish2019
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LIBRIS-ID:oai:gup.ub.gu.se/285594
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https://gup.ub.gu.se/publication/285594URI
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https://doi.org/10.1097/HJH.0000000000002163DOI
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
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The aim of this study was to compare the risk of cardiovascular disease (CVD) - nonfatal acute myocardial infarction (AMI) or stroke - at blood pressure levels that meet current recommendations with risk at lower levels, particularly in older patients.We identified patients with hypertension aged 40-90 years from a primary care register. Patients with a history of cancer, diabetes mellitus or CVD were excluded. Patients were divided into age groups (40-75 and 76-90), and four groups of SBP 110-129, 130-139 (reference), 140-149 and ≥150mmHg. We used the Kaplan-Meier estimator to study incidence of AMI, stroke and a composite of the two. Cox proportional-hazards regression was used to estimate hazard ratios for outcomes.We included 31704 patients: 26663 were 40-75 years old and 5041 were 76-90 years old. Mean follow-up was 2 years. Although no significant differences in risk of any outcome were found in the younger group, low blood pressure was associated with the lowest risk in the older group. Older patients in the 110-129mmHg group had a lower incidence of CVD (15.9/1000 vs. 25.3/1000 person-years) than the reference group. After adjustment for covariates, the hazard ratio of CVD in older patients in the 110-129mmHg group compared with the reference group was 0.60 (95% confidence interval 0.40-0.92).Blood pressure levels lower than those currently recommended are not harmful among older patients. The association between lower SBP and lesser risk of CVD may instead suggest a beneficial effect of lower SBP.
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Hjerpe, PerGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa,Institute of Medicine, School of Public Health and Community Medicine
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Manhem, Karin,1954Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xmanka
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Björck, Staffan
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Franzén, Stefan,1967
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Rosengren, Annika,1951Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xrosan
(author)
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Adamsson Eryd, SamuelGothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xadasa
(author)
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Göteborgs universitetInstitutionen för medicin, avdelningen för molekylär och klinisk medicin
(creator_code:org_t)
Related titles
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In:Journal of hypertension37:11, s. 2269-22791473-5598
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