Impact of Hypertension on Hospitalizations for Cardiovascular Diseases in a Worksite Population: An Epidemiologic Study Using Claims Data for Workers
Impact of Hypertension on Hospitalizations for Cardiovascular Diseases in a Worksite Population: An Epidemiologic Study Using Claims Data for Workers
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DOI：
10.1093/ajh/hpy177
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发表时间：
2019-03-01
影响因子：
3.2
通讯作者：
Toumi, Mondher
中科院分区：
文献类型：
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作者：
Fukushima, Ayako;Khabtheni, Wafa;Toumi, Mondher
背景：很少有研究调查了抗高血压药物在工作人群中的作用。我们的目的是描述高血压合并和不合并抗高血压药物对日本工作人群因心血管疾病（cvd）住院的影响。方法：这项回顾性研究纳入了年龄在40-64岁之间的成年人，他们的收缩压和舒张压（BP）读数在2008年至2015年期间可在日本索赔数据库中获得。根据患者的高血压治疗史，将患者分为治疗组(T)和未治疗组（UT）。使用Cox模型比较不同血压水平个体到首次心血管相关住院的时间，该模型包括基线血压水平的基线特征或反映血压随时间变化的时间相关变量。结果：在740,784例UT患者（男性：61.9%，平均年龄：47.9岁）中，在957.3天的平均随访期间，有2,121例患者因心血管疾病住院。在72,828例（男性：74.3%，平均年龄：53.7岁）中，在平均813.4天的随访中，相应的数据为470例。在UT组中，住院风险随着基线高血压严重程度的增加而增加（1级、2级和3级的危险比[hr]分别为1.93、2.82和6.32;P < 0.0001，参考值：最佳），但在T组中没有。与非高血压患者相比，在任何给定时间伴有高血压的UT患者住院的概率显著更高（HR = 1.74, P < 0.0001）。结论：本研究为高血压对日本工作人群心血管疾病相关住院风险的影响提供了定量证据。这表明抗高血压治疗在相对年轻的40-64岁的工作人群中有有益的效果。
BACKGROUND Few of studies investigated the effect of antihypertensives among working population. We aimed to describe the impact of hypertension with and without antihypertensives on hospitalizations because of cardiovascular diseases (CVDs) in the Japanese working population.METHODS This retrospective study included adults aged 40-64 years whose systolic and diastolic blood pressure (BP) readings taken between 2008 and 2015 were available in the Japanese claims database. Individuals were categorized as treated (T) or untreated (UT) depending on their hypertension treatment history. Time to first CVD-related hospitalization was compared among individuals with different BP levels using Cox models that included baseline characteristics with either baseline BP level or a time-dependent variable reflecting BP changes over time.RESULTS Of 740,784 UT individuals (male: 61.9%, mean age: 47.9 years), 2,121 individuals were hospitalized due to a CVD over a 957.3-day average follow-up. Among 72,828 T individuals (male: 74.3%, mean age: 53.7 years), the corresponding figure was 470 individuals over an 813.4-day average follow-up. The risk of hospitalization increased with baseline hypertension severity among UT (hazard ratios [HRs] = 1.93, 2.82, and 6.32 for grade 1, grade 2, and grade 3, respectively; P < 0.0001, reference: optimal) but not among T individuals. UT individuals with hypertension at any given time had a significantly higher probability of hospitalization compared to nonhypertensive individuals (HR = 1.74, P < 0.0001).CONCLUSIONS This study adds quantitative evidence on the impact of hypertension on the risk of CVD-related hospitalization in the Japanese working population. It suggests that antihypertensive treatment had beneficial effects in this relatively young, working population aged 40-64 years.