Mortality in persons with undetected and diagnosed hypertension, type 2 diabetes, and hypothyroidism, compared with persons without corresponding disease - a prospective cohort study; The HUNT Study, Norway

BMC Family Practice

Research Article

Pål Jørgensen¹  Siri Forsmo¹  Arnulf Langhammer²  Steinar Krokstad³ 

[1] Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Postbox 8905, 7491, Trondheim, Norway;HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway;HUNT Research Centre, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Levanger, Norway;Levanger Hospital, Nord-Trøndelag Hospital Trust, 7600, Levanger, Norway;

关键词: Chronic disease;    Diabetes;    Hypertension;    Thyroid disorders;    Primary care;    Public health;   

DOI  :  10.1186/s12875-017-0672-7

 received in 2017-06-08, accepted in 2017-11-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundSuggested strategies in reducing the impact of non-communicable diseases (NCD) are early diagnosing and screening. We have limited proof of benefit of population screening for NCD. Increased mortality in persons with diagnosed NCD has been shown for decades. However, mortality in undetected NCD has barely been studied. This paper explores whether all-cause mortality differed between persons with diagnosed hypothyroidism, type 2 diabetes (T2DM), and hypertension, compared with persons with undetected-, and with persons without the corresponding disease.MethodsA prospective cohort study of the general population in Nord-Trøndelag, Norway. Persons ≥20 years at baseline 1995–97 were followed until death or June 15, 2016. Cox proportional hazards models were used to compute age and multiple adjusted hazard ratios (HR) with 95% confidence intervals (CI) for the association between disease status and all-cause mortality. The number of participants in the hypothyroidism study was 31,960, in the T2DM study 37,957, and in the hypertension study 63,371.ResultsMortality was increased in persons with diagnosed type 2 diabetes and hypertension, compared to persons without corresponding disease; HR 1.69 (95% CI 1.55–1.84) and HR 1.23 (95% CI 1.09–1.39), respectively. Among persons with undetected T2DM, the HR was 1.21 (95% CI 1.08–1.37), whilst among undetected hypothyroidism and hypertension, mortality was not increased compared with persons without the diseases. Further, the association with mortality was stronger in persons with long duration of T2DM (HR 1.96 (95% CI 1.57–2.44)) and hypertension (HR 1.32 (95% CI 1.17–1.49)), compared with persons with short duration (HR 1.29 (1.09–1.53) and HR 1.16 (1.03-1-30) respectively).ConclusionsMortality was increased in persons with diagnosed T2DM and hypertension, and in undetected T2DM, compared with persons without the diseases. The strength of the association with mortality in undetected T2DM was however lower compared with persons with diagnosed T2DM, and mortality was not increased in persons with undetected hypothyroidism and hypertension, compared with persons without the diseases. Thus, future research needs to test more thoroughly if early diagnosing of these diseases, such as general population screening, is beneficial for health.

【 授权许可】

CC BY   
© The Author(s). 2017