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Gut Liver. 2019 Apr 11. doi: 10.5009/gnl18510. [Epub ahead of print]

Effect of Helicobacter pylori Treatment on Long-Term Mortality in Patients with Hypertension.

Author information

1
Center for Gastric Cancer, National Cancer Center, Goyang, Korea.
2
Cancer Survivorship Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
3
Dongguk University College of Korean Medicine, Gyeongju.
4
Department of Cardiology, Center for Clinical Specialty, National Cancer Center, Goyang, Korea.
5
Department of Neurology, Research Institute and Hospital, National Cancer Center, Goyang, Korea.
6
Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea.
7
of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
8
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract

Background/Aims:

: A meta-analysis of randomized trials performed in healthy asymptomaticindividuals suggested that overall mortality may increase after Helicobacter pylori eradication despitea significant decrease in the gastric cancer incidence and mortality rates. This retrospective populationbasedcohort study investigated if H. pylori treatment is associated with an increase in overall mortalityin patients with hypertension.

Methods:

: From the database of the Korean National Health InsuranceSample Cohort, we selected 198,487 patients treated for hypertension between 2002 and 2010. Thosewho received H. pylori treatment (Hp treatment cohort, 5,541 patients) were matched to those who didnot (nontreatment cohort, 11,082 patients) at a 1 to 2 ratio. The primary outcome was the risk of overallmortality. The secondary outcomes were the risks of mortality due to cardiovascular disease,cerebrovascular disease, and cancer. The outcomes were evaluated from 6 months after H. pyloritreatment to December 2013. A Cox proportional hazard model was used to estimate the hazard ratios(HRs).

Results:

: During a median follow-up period of 4.8 years, death from any cause was reported in4.1% of the patients in the Hp treatment cohort and 5.5% of the patients in the nontreatment cohort. Theadjusted HR (aHR) for overall mortality in the Hp treatment cohort was 0.70 (95% confidence interval[CI], 0.60 to 0.82; p<0.001). With regard to cause-specific mortality, compared with the nontreatmentcohort, the Hp treatment cohort had a lower risk of mortality due to cerebrovascular disease (aHR, 0.46;95% CI, 0.26 to 0.81; p=0.007). The risks of mortality due to cancer and cardiovascular disease werenot different between the cohorts.

Conclusions:

: H. pylori treatment is not associated with an increasein overall mortality in patients treated for hypertension.

KEYWORDS:

Helicobacter pylori; Hypertension; Mortality

PMID:
30974928
DOI:
10.5009/gnl18510
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