Cardiovascular Mortality Of Mediterranean Population Hypertensive > 65 Years

Objective: In Spain, hypertension is a health problem of the first magnitude. The importance of determining the cardiovascular risk (CVR) associated with high blood pressure is based on the evidence that most hypertensive patients have additional CVR factors that, when concurrent with hypertension, enhance each other, giving rise to a CVR total that is greater than the sum of its components. Our objective was to assess the cardiovascular mortality of this population group. Design and method: Epidemiological, observational, longitudinal, prospective and multicentre study of the care setting, carried out in the Valencia Community with a hypertensive population over 65 years of age that went to the Health Centre or to a Hospital Unit of Hypertension (FAPRES Registry). For analysis of the data we used the program IBM - SPSS Windows version 20 with a statistical significance of p < 0.05. Results: Of the 1,028-hypertensive patients basally included, 1,003 patients (97.6%) completed the follow-up after a median of 803 (721–896) days. Of these, 21 of them died from causes of non-CV origin. In the follow-up of the remaining 982 patients, 20 died of cardiovascular cause. The deceased presented the following statistically significant differences: Higher percentage of male sex. Older middle age. Higher frequency of history of heart failure and/or coronary disease. Lower diastolic blood pressure. Higher percentage of anticoagulant and/or antiaggregant treatment. Lower levels of HDL-cholesterol. More prevalence of atrial fibrillation and Q wave of necrosis in the electrocardiogram. In the multivariate analysis, the factors associated with cardiovascular mortality were age and previous coronary disease. On the contrary, the history of hypercholesterolemia, the increase in HDL-cholesterol and the performance of physical exercise were associated with lower mortality. Although no significant differences were found, a trend toward higher cardiovascular mortality was observed in antiaggregate patients. In contrast, the decrease in mean clinical diastolic blood pressure showed a trend towards increased mortality. Conclusions: Physical exercise and the increase of HDL-cholesterol prevent cardiovascular mortality, from which the importance of it in hypertensive patients over 65 years of age is deduced.