COMPARATIVE STUDY OF ANTIHYPERTENSIVE DRUG REGIMENS AND MORTALITY IN THE GLASGOW BLOOD PRESSURE CLINIC: 2B.01

Abstract

Aim: To investigate the relationship between antihypertensive regimen and mortality in a long-term follow up study of hypertensive patients attending a secondary tertiary referral centre. Methods: We studied the effects of various antihypertensive treatment regimens on mortality at the Glasgow Blood Pressure Clinic (GBPC). Patients were classified according to treatment regimen maintained for the longest period of time between years 2 and 5 of follow up. Classification was based on the 4 major antihypertensive drug groups: ACEi/ARB (A); beta-blockers (B); calcium antagonists (C); diuretics (D). Treated patients not on any ABCD drug were grouped into one category. Survival analyses were performed using Cox proportional hazards model. Covariates included age, sex, BMI, cholesterol, achieved systolic BP, smoking and epoch defined by publication of major UK hypertension treatment guidelines. Results: During 20 years of follow up, there were 1546 deaths among the 5467 patients included in the study (mean age = 53 years, males = 48% at baseline). The mean reduction in BP pressure during follow up was 25 ± 28 mmHg. Despite adjustment for achieved BP, patients on BD combination showed the highest mortality, while patients on AD had the lowest mortality. Compared with AD combination, all of the other regimens were associated with higher mortality (Figure). Conclusion: In this GBPC cohort, AD combination is associated with lower all-cause mortality when compared to all other antihypertensive drug strategies.