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Antihypertensive treatment, high triglycerides, and low high-density lipoprotein cholesterol and risk of ischemic heart disease mortality: a 16-year follow-up in the Copenhagen male study.
Metab Syndr Relat Disord 2010; 8(3):215-22MS

Abstract

OBJECTIVE

The aim of this study was to test the hypothesis that metabolic syndrome dyslipidemia is a major risk factor for ischemic heart disease (IHD) mortality among men taking antihypertensive medication.

METHODS

This was a 16-year follow up of 2,986 men 53-75 years old without overt cardiovascular disease; 357 men used antihypertensive medicine. Potential risk factors were type of baseline medication, blood pressure, diabetes, fasting serum triglycerides (TG), high-density lipoprotein (HDL-C) and total cholesterol, glucosuria, electrocardiogram (ECG) changes, cancer history, body mass index, alcohol and tobacco use, leisure time physical activity, social class, and age. The main outcome was IHD mortality.

RESULTS

Men treated for hypertension had a two-fold higher cumulative incidence of IHD mortality during the follow up compared to other men (12.0% vs, 5.8%). Dyslipidemia was defined as TG >or=1.70 mmol/L or HDL-C <or=1.03 mmol/L. Among men without any dyslipidemia (n = 159 or 46%), in Cox analysis adjusted for age only, the hazard ratio (HR) with 95% confidence interval (CI) for IHD mortality was 1.2 (0.6-2.3) compared to untreated normotensives (n = 1,953). Among men with one dyslipidemia (n = 116 or 34%) HR was 2.2 (1.2-4.0), and among men with combined dyslipidemia (n = 71 or 20%) HR was 6.0 (3.5-10.2). Adjustment for relevant confounders attenuated the three HRs to 0.8 (0.4-1.7), 1.6 (0.9-3.1), and 4.5 (2.5-8.2), respectively. Measured blood pressure was not associated with IHD mortality risk among men on antihypertensive medication.

CONCLUSIONS

TG and HDL-C dyslipidemia were strong effect modifiers. Men on antihypertensive medication had no increased risk of IHD mortality compared to untreated normotensive men, provided they were free from high TG and low HDL-C dyslipidemia.

Authors+Show Affiliations

Copenhagen Male Study, Epidemiologic Research Unit, Copenhagen University Hospital, Bispebjerg, Denmark. ps11@bbh.regionh.dkNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20156073

Citation

Suadicani, Poul, et al. "Antihypertensive Treatment, High Triglycerides, and Low High-density Lipoprotein Cholesterol and Risk of Ischemic Heart Disease Mortality: a 16-year Follow-up in the Copenhagen Male Study." Metabolic Syndrome and Related Disorders, vol. 8, no. 3, 2010, pp. 215-22.
Suadicani P, Hein HO, Gyntelberg F. Antihypertensive treatment, high triglycerides, and low high-density lipoprotein cholesterol and risk of ischemic heart disease mortality: a 16-year follow-up in the Copenhagen male study. Metab Syndr Relat Disord. 2010;8(3):215-22.
Suadicani, P., Hein, H. O., & Gyntelberg, F. (2010). Antihypertensive treatment, high triglycerides, and low high-density lipoprotein cholesterol and risk of ischemic heart disease mortality: a 16-year follow-up in the Copenhagen male study. Metabolic Syndrome and Related Disorders, 8(3), pp. 215-22. doi:10.1089/met.2009.0072.
Suadicani P, Hein HO, Gyntelberg F. Antihypertensive Treatment, High Triglycerides, and Low High-density Lipoprotein Cholesterol and Risk of Ischemic Heart Disease Mortality: a 16-year Follow-up in the Copenhagen Male Study. Metab Syndr Relat Disord. 2010;8(3):215-22. PubMed PMID: 20156073.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antihypertensive treatment, high triglycerides, and low high-density lipoprotein cholesterol and risk of ischemic heart disease mortality: a 16-year follow-up in the Copenhagen male study. AU - Suadicani,Poul, AU - Hein,Hans Ole, AU - Gyntelberg,Finn, PY - 2010/2/17/entrez PY - 2010/2/17/pubmed PY - 2010/9/15/medline SP - 215 EP - 22 JF - Metabolic syndrome and related disorders JO - Metab Syndr Relat Disord VL - 8 IS - 3 N2 - OBJECTIVE: The aim of this study was to test the hypothesis that metabolic syndrome dyslipidemia is a major risk factor for ischemic heart disease (IHD) mortality among men taking antihypertensive medication. METHODS: This was a 16-year follow up of 2,986 men 53-75 years old without overt cardiovascular disease; 357 men used antihypertensive medicine. Potential risk factors were type of baseline medication, blood pressure, diabetes, fasting serum triglycerides (TG), high-density lipoprotein (HDL-C) and total cholesterol, glucosuria, electrocardiogram (ECG) changes, cancer history, body mass index, alcohol and tobacco use, leisure time physical activity, social class, and age. The main outcome was IHD mortality. RESULTS: Men treated for hypertension had a two-fold higher cumulative incidence of IHD mortality during the follow up compared to other men (12.0% vs, 5.8%). Dyslipidemia was defined as TG >or=1.70 mmol/L or HDL-C <or=1.03 mmol/L. Among men without any dyslipidemia (n = 159 or 46%), in Cox analysis adjusted for age only, the hazard ratio (HR) with 95% confidence interval (CI) for IHD mortality was 1.2 (0.6-2.3) compared to untreated normotensives (n = 1,953). Among men with one dyslipidemia (n = 116 or 34%) HR was 2.2 (1.2-4.0), and among men with combined dyslipidemia (n = 71 or 20%) HR was 6.0 (3.5-10.2). Adjustment for relevant confounders attenuated the three HRs to 0.8 (0.4-1.7), 1.6 (0.9-3.1), and 4.5 (2.5-8.2), respectively. Measured blood pressure was not associated with IHD mortality risk among men on antihypertensive medication. CONCLUSIONS: TG and HDL-C dyslipidemia were strong effect modifiers. Men on antihypertensive medication had no increased risk of IHD mortality compared to untreated normotensive men, provided they were free from high TG and low HDL-C dyslipidemia. SN - 1557-8518 UR - https://www.unboundmedicine.com/medline/citation/20156073/Antihypertensive_treatment_high_triglycerides_and_low_high_density_lipoprotein_cholesterol_and_risk_of_ischemic_heart_disease_mortality:_a_16_year_follow_up_in_the_Copenhagen_male_study_ L2 - https://www.liebertpub.com/doi/full/10.1089/met.2009.0072?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -