Document Detail


Hematocrit predicts long-term mortality in a nonlinear and sex-specific manner in hypertensive adults.
MedLine Citation:
PMID:  22802225     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Laura Paul; Panniyammakal Jeemon; Jonathan Hewitt; Linsay McCallum; Peter Higgins; Matthew Walters; John McClure; Jesse Dawson; Peter Meredith; Gregory C Jones; Scott Muir; Anna F Dominiczak; Gordon Lowe; Gordon T McInnes; Sandosh Padmanabhan
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-07-16
Journal Detail:
Title:  Hypertension     Volume:  60     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-16     Completed Date:  2013-01-07     Revised Date:  2014-03-19    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  631-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Pressure / physiology*
Cardiovascular Diseases / etiology,  mortality,  physiopathology
Cohort Studies
Female
Follow-Up Studies
Hematocrit*
Humans
Hypertension / complications,  mortality*,  physiopathology*
Kaplan-Meier Estimate
Longitudinal Studies
Male
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Risk Factors
Sex Characteristics*
Grant Support
ID/Acronym/Agency:
084754//Wellcome Trust; //British Heart Foundation; //Wellcome Trust

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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