A sudden death risk score specifically for hypertension: based on 25 648 individual patient data from six randomized controlled trials.

Details

Serval ID
serval:BIB_5E95379DED17
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
A sudden death risk score specifically for hypertension: based on 25 648 individual patient data from six randomized controlled trials.
Journal
Journal of hypertension
Author(s)
Le H.H., Subtil F., Cerou M., Marchant I., Al-Gobari M., Fall M., Mimouni Y., Kassaï B., Lindholm L., Thijs L., Gueyffier F.
ISSN
1473-5598 (Electronic)
ISSN-L
0263-6352
Publication state
Published
Issued date
11/2017
Peer-reviewed
Oui
Volume
35
Number
11
Pages
2178-2184
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
To construct a sudden death risk score specifically for hypertension (HYSUD) patients with or without cardiovascular history.
Data were collected from six randomized controlled trials of antihypertensive treatments with 8044 women and 17 604 men differing in age ranges and blood pressure eligibility criteria. In total, 345 sudden deaths (1.35%) occurred during a mean follow-up of 5.16 years. Risk factors of sudden death were examined using a multivariable Cox proportional hazards model adjusted on trials. The model was transformed to an integer system, with points added for each factor according to its association with sudden death risk.
Antihypertensive treatment was not associated with a reduction of the sudden death risk and had no interaction with other factors, allowing model development on both treatment and placebo groups. A risk score of sudden death in 5 years was built with seven significant risk factors: age, sex, SBP, serum total cholesterol, cigarette smoking, diabetes, and history of myocardial infarction. In terms of discrimination performance, HYSUD model was adequate with areas under the receiver operating characteristic curve of 77.74% (confidence interval 95%, 74.13-81.35) for the derivation set, of 77.46% (74.09-80.83) for the validation set, and of 79.17% (75.94-82.40) for the whole population.
Our work provides a simple risk-scoring system for sudden death prediction in hypertension, using individual data from six randomized controlled trials of antihypertensive treatments. HYSUD score could help assessing a hypertensive individual's risk of sudden death and optimizing preventive therapeutic strategies for these patients.

Keywords
Adult, Aged, Death, Sudden/epidemiology, Female, Humans, Hypertension/epidemiology, Male, Middle Aged, Myocardial Infarction, Proportional Hazards Models, Randomized Controlled Trials as Topic, Risk Factors
Pubmed
Web of science
Create date
06/07/2017 17:49
Last modification date
20/08/2019 15:16
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