Geneology International

Tag: mortality

  • Healthy lifestyle, medication adherence tied to lower mortality in hypertension

    Healthy lifestyle, medication adherence tied to lower mortality in hypertension

    February 01, 2022

    3 min read

    Disclosures:
    The authors report no relevant financial disclosures.


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    The combination of healthy lifestyle and adherence to antihypertensive medications was associated with decreased risk for mortality in patients with hypertension, according to data in JAMA Network Open.

    “No study has examined the joint association of antihypertensive medication use and healthy lifestyle with mortality among individuals with hypertension, to our knowledge. In addition, whether improvement in lifestyle may yield health benefits for individuals with hypertension is unclear,” Qi Lu, MBBS, of the department of nutrition and food hygiene at the Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (Incubating) at Tongji Medical College, Huazhong University of Science and Technology in Wuhan, China, and colleagues wrote. “To fill these knowledge gaps, we aimed to prospectively examine the association of antihypertensive medication use and healthy lifestyle, as well as changes in lifestyle, with risk of all-cause and cause-specific mortality among middle-aged and elderly adults with hypertension in China.”

    Graphical depiction of data presented in article
    Data were derived from Lu Q, et al. JAMA Netw Open. 2022;doi:10.1001/jamanetworkopen.2021.46118.

    Utilizing data from the Dongfeng-Tongji prospective cohort of employees at the Dongfeng Motor Corporation in China, researchers evaluated lifestyle factors, including BMI, smoking status, diet, physical activity and sleep duration. Lifestyle factors were scored on a scale of 0 to 2, with a higher score indicating a healthier lifestyle. Each participant’s total score of all five lifestyle factors was categorized as unfavorable (scores 0 to 4), intermediate (scores 5 to 7) and favorable (scores 8 to 10). Antihypertensive medication use was defined as use within the prior 2 weeks.

    Lifestyle, antihypertensive use and mortality risk

    The cohort included 14,392 participants with hypertension (mean age, 66 years; 51{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} men).

    Researchers observed that individuals who took antihypertensive medications and were categorized with a favorable lifestyle had the lower risk for all-cause mortality (HR = 0.32; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.25-0.42), CVD mortality (HR = 0.33; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.21-0.53) and cancer mortality (HR = 0.3; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.19-0.47) compared with those who were not using antihypertensives nor following an unfavorable lifestyle.

    “The association was independent of traditional risk factors, including hypertension duration, common comorbidities, use of hypoglycemic and lipid-lowering medication, metabolic biomarkers and mental stress,” the researchers wrote.

    In addition, participants who did not take antihypertensive medication treatment but adopted a favorable lifestyle experienced lower risk for all-cause mortality (HR = 0.34; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.25-0.46), CVD mortality (HR = 0.4; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.24-0.67) and cancer mortality (HR = 0.33; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.19-0.55), compared with those who did not take medication and had an unfavorable lifestyle. However, participants who were taking antihypertensive medication but following an unfavorable lifestyle experienced no reduction in CVD mortality (HR = 0.71; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.43-1.17) or cancer mortality (HR = 0.64; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.38-1.07) compared with those who did not take medication and had an unfavorable lifestyle, but the medication/unfavorable lifestyle group did have reduced risk for all-cause mortality compared with the no medication/unfavorable lifestyle group (HR = 0.7; 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI, 0.52-0.94), according to the study.

    Improving risk by improving lifestyle score

    Researchers observed that for every 1-point increase in lifestyle score in participants not taking antihypertensive medication, risk for all-cause mortality decreased 17{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}, risk for CVD mortality decreased 15{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} and risk for cancer mortality decreased 18{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}. Among those who were taking antihypertensive medications, every 1-point increase in lifestyle score was associated with a 14{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} lower risk for all-cause mortality, 14{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} lower risk for CVD mortality and 13{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} lower risk for cancer mortality.

    According to the study, there was no significant interaction between antihypertensive medication use and lifestyle score.

    “Individuals using antihypertensive medication and following a favorable lifestyle had the lowest risk of all-cause, CVD, and cancer mortality,” the researchers wrote. “There were inverse linear associations between lifestyle score and mortality, regardless of hypertensive medication use. Additionally, for participants with an unfavorable lifestyle, there was no significant reduction in mortality risk even if they were using antihypertensive medication. Furthermore, we found that improvement in lifestyle after hypertension diagnosis was associated with significantly lower risk of subsequent death. From a public health perspective, BP management and complication prevention have great health and socioeconomic benefits, considering that the annual cost of hypertension has reached tens of billions of dollars per country.”


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  • Anti-hypertensive use combined with healthy lifestyle significantly reduces mortality risk

    Anti-hypertensive use combined with healthy lifestyle significantly reduces mortality risk

    Anti-hypertensive drug use in combination with a healthier life-style is involved with the finest reduction in all will cause of demise

    The use of anti-hypertensive medications when merged with nutritious lifestyle measures appears to be the most effective system to reduce all-induce and result in-unique mortality. This is according to a study by Chinese researchers from the Department of Epidemiology and Biostatistics, College of Community Health, Huazhong College of Science and Technological innovation, Hubei, China.

    Hypertension significantly raises the challenges of heart, mind, kidney and other illnesses and in accordance to the Earth Overall health Organisation, an approximated 1.28 billion grown ups aged 30-79 several years throughout the world have hypertension, most of whom are residing in very low- and center-profits international locations. In addition, a 2019 examination calculated that a higher systolic blood stress accounted for roughly 10·8 million fatalities which was 19.2{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of all recorded fatalities in 2019. Hypertension is managed with a vary of various lessons of medicines, nonetheless non-adherence to anti-hypertensive treatment method impacts 10{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}–80{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} of hypertensive individuals and is one of the vital drivers of suboptimal BP regulate. With respect to life-style modification, there is potent evidence supporting the positive aspects of standard bodily action and training for the prevention and administration of hypertension. However, no matter if the blend of anti-hypertensive medication and healthful way of living steps yields additional added benefits and if adoption of nutritious life style steps following a prognosis of hypertension supplies a mortality profit remains uncertain.

    For the current examine, the Chinese crew examined the romance in between anti-hypertensive use and life style actions and the impact of this on all-bring about and trigger-precise mortality among the hypertensive patients. They utilized data from the Dongfeng-Tongji cohort, which prospectively adopted hypertensive patients for a median of 7.3 yrs. The staff assessed precise way of living elements together with human body mass index, using tobacco position, food plan, physical action and sleep period and computed an in general life style rating centered on these five attributes, with higher scores (ranging from to 10) indicating a much healthier lifestyle. In addition, members were being categorised into the pursuing subgroups: favourable way of living (scores 8 – 10), intermediate (5- 7) and unfavourable ( – 4). The use of anti-hypertensive medicine was dichotomised into sure or no.

    Anti-hypertensive use and subsequent mortality

    A whole of 14,392 members with a imply age of 65.6 many years (50.6{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} male) employing anti-hypertensive medicines had been integrated in the analysis. In excess of a median of 7.3 a long time, there had been 2015 deaths including 761 owing to cardiovascular condition and 525 from cancer. Using folks not making use of anti-hypertensives and pursuing an unfavourable life-style as the reference group, people applying anti-hypertensives and with a favourable lifestyle experienced the cheapest risk of all-result in mortality (hazard ratio, HR = .32, 95{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} CI .25 – .42). This was also legitimate for cardiovascular mortality (HR = .33) and death owing to most cancers (HR = .30).

    Curiously, when utilizing the very same reference team, people today who had been not applying anti-hypertensives but adopted a favourable life style, also experienced a decrease possibility of all-trigger mortality (HR = .34), cardiovascular (HR = .40) and most cancers mortality (HR = .33). In reality, there was a linear association with way of life score and mortality, these kinds of that irrespective or anti-hypertensive medicine use, every 1-stage raise in lifestyle score was related with a 17{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c} decreased threat of all-trigger mortality, with similar reductions for cardiovascular and most cancers deaths.

    There was also a lessened mortality chance by the adoption of way of living steps soon after a diagnosis of hypertension. For example, compared to people with a continuously reduced way of living rating between baseline and the to start with follow-up, individuals who instigated a adjust in lifestyle score from lower to significant also had a noticeably lessened hazard for all-bring about (HR = .52), cardiovascular (HR = .53) mortality whilst the decreased danger of most cancers mortality was non-important.

    The authors concluded that the merged outcome of anti-hypertensive treatment and adoption of a nutritious lifestyle resulted in a significantly lessened hazard of all and certain result in mortality.

    Citation
    Lu Q et al. Association of Way of living Factors and Antihypertensive Treatment Use With Chance of All-Induce and Trigger-Unique Mortality Among the Adults With Hypertension in China JAMA Netw Open up 2022