Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All‐Cause and Cardiovascular Mortality: Evidence From a Cohort Study

ABSTRACT Screenings for hypertension, diabetes, and high cholesterol are widely conducted in routine clinical practice for cardiovascular disease (CVD) prevention. However, few studies have investigated whether these screenings could eventually lead to lower risks of hard outcomes such as mortality....

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Main Authors: Jiayue Zhang, Shuting Wang, Ying Huang, Wenxiao Zheng, Ying Xiao, Zuyao Yang
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:The Journal of Clinical Hypertension
Subjects:
Online Access:https://doi.org/10.1111/jch.70053
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author Jiayue Zhang
Shuting Wang
Ying Huang
Wenxiao Zheng
Ying Xiao
Zuyao Yang
author_facet Jiayue Zhang
Shuting Wang
Ying Huang
Wenxiao Zheng
Ying Xiao
Zuyao Yang
author_sort Jiayue Zhang
collection DOAJ
description ABSTRACT Screenings for hypertension, diabetes, and high cholesterol are widely conducted in routine clinical practice for cardiovascular disease (CVD) prevention. However, few studies have investigated whether these screenings could eventually lead to lower risks of hard outcomes such as mortality. This cohort study aimed to examine directly the association of screenings for hypertension, diabetes, and high cholesterol with all‐cause and cardiovascular mortality and whether the association, if existent, varied with important characteristics. A nationally representative sample of 86 587 US adults without the three conditions and CVD at baseline were recruited. The history of screenings for the three conditions was elicited by a series of questions in the surveys. All‐cause and cardiovascular mortality were ascertained by linkage to National Death Index records through December 31, 2019. The association of screenings with mortality was investigated by multivariable Cox regression analysis and expressed as hazard ratio (HR) with 95% confidence interval (CI), adjusting for major risk factors of CVD and mortality. The “1 screening,” “2 screenings,” “3 screenings,” and “any screening” (combining the above three) groups were compared with the “no screening” group separately. During a median follow‐up of 51 months (4.3 years), 1783 participants died and 366 of them were attributed to CVD. After adjusting for all covariates, no statistically significant association was found between “any screening” and all‐cause mortality (HR = 1.08, 95% CI 0.92–1.26) or cardiovascular mortality (HR = 1.06, 95% CI 0.76–1.47). The results were consistent across various subgroups. The associations of “1 screening,” “2 screenings,” and “3 screenings” respectively with all‐cause and cardiovascular mortality were not statistically significant either (HRs ranging from 0.65 to 1.40). Overall, in this population of US general adults, there was no evidence that screening for hypertension, diabetes, and high cholesterol could lead to lower all‐cause or cardiovascular mortality.
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spelling doaj-art-e8d2242a6b8d41eda582741dc0ffe96d2025-08-20T02:03:07ZengWileyThe Journal of Clinical Hypertension1524-61751751-71762025-05-01275n/an/a10.1111/jch.70053Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All‐Cause and Cardiovascular Mortality: Evidence From a Cohort StudyJiayue Zhang0Shuting Wang1Ying Huang2Wenxiao Zheng3Ying Xiao4Zuyao Yang5Faculty of MedicineMacau University of Science and TechnologyMacao Special Administrative Region ChinaThe Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative Region ChinaThe Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative Region ChinaThe Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative Region ChinaFaculty of MedicineMacau University of Science and TechnologyMacao Special Administrative Region ChinaThe Jockey Club School of Public Health and Primary CareThe Chinese University of Hong KongHong Kong Special Administrative Region ChinaABSTRACT Screenings for hypertension, diabetes, and high cholesterol are widely conducted in routine clinical practice for cardiovascular disease (CVD) prevention. However, few studies have investigated whether these screenings could eventually lead to lower risks of hard outcomes such as mortality. This cohort study aimed to examine directly the association of screenings for hypertension, diabetes, and high cholesterol with all‐cause and cardiovascular mortality and whether the association, if existent, varied with important characteristics. A nationally representative sample of 86 587 US adults without the three conditions and CVD at baseline were recruited. The history of screenings for the three conditions was elicited by a series of questions in the surveys. All‐cause and cardiovascular mortality were ascertained by linkage to National Death Index records through December 31, 2019. The association of screenings with mortality was investigated by multivariable Cox regression analysis and expressed as hazard ratio (HR) with 95% confidence interval (CI), adjusting for major risk factors of CVD and mortality. The “1 screening,” “2 screenings,” “3 screenings,” and “any screening” (combining the above three) groups were compared with the “no screening” group separately. During a median follow‐up of 51 months (4.3 years), 1783 participants died and 366 of them were attributed to CVD. After adjusting for all covariates, no statistically significant association was found between “any screening” and all‐cause mortality (HR = 1.08, 95% CI 0.92–1.26) or cardiovascular mortality (HR = 1.06, 95% CI 0.76–1.47). The results were consistent across various subgroups. The associations of “1 screening,” “2 screenings,” and “3 screenings” respectively with all‐cause and cardiovascular mortality were not statistically significant either (HRs ranging from 0.65 to 1.40). Overall, in this population of US general adults, there was no evidence that screening for hypertension, diabetes, and high cholesterol could lead to lower all‐cause or cardiovascular mortality.https://doi.org/10.1111/jch.70053cardiovascular diseasecohort studydiabeteshigh cholesterolhypertensionmortality
spellingShingle Jiayue Zhang
Shuting Wang
Ying Huang
Wenxiao Zheng
Ying Xiao
Zuyao Yang
Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All‐Cause and Cardiovascular Mortality: Evidence From a Cohort Study
The Journal of Clinical Hypertension
cardiovascular disease
cohort study
diabetes
high cholesterol
hypertension
mortality
title Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All‐Cause and Cardiovascular Mortality: Evidence From a Cohort Study
title_full Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All‐Cause and Cardiovascular Mortality: Evidence From a Cohort Study
title_fullStr Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All‐Cause and Cardiovascular Mortality: Evidence From a Cohort Study
title_full_unstemmed Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All‐Cause and Cardiovascular Mortality: Evidence From a Cohort Study
title_short Association of Screenings for Hypertension, Diabetes, and High Cholesterol With All‐Cause and Cardiovascular Mortality: Evidence From a Cohort Study
title_sort association of screenings for hypertension diabetes and high cholesterol with all cause and cardiovascular mortality evidence from a cohort study
topic cardiovascular disease
cohort study
diabetes
high cholesterol
hypertension
mortality
url https://doi.org/10.1111/jch.70053
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