Table 3.
Incidence and risk of acute cardiovascular events after acute respiratory infection by cardiovascular risk group
| Number of events | Incidence per 1000 person-years (95% CI) | Crude HR (95% CI) | Age and sex-adjusted HR (95% CI) | Fully adjusted*HR (95% CI) | |
|---|---|---|---|---|---|
| Any cardiovascular event | |||||
| Hypertension | 985 | 11·2 (10·5–12·0) | 2·08 (1·93–2·23) | 1·97 (1·84–2·12) | 1·98 (1·83–2·15) |
| No hypertension | 3184 | 5·8 (5·6–6·0) | 1 (ref) | 1 (ref) | 1 (ref) |
| QRISK2 ≥10% | 1526 | 17·5 (16·7–18·5) | 3·74 (3·51–3·98) | NA | 3·65 (3·42–3·89) |
| QRISK2 <10% | 2643 | 4·8 (4·6–5·0) | 1 (ref) | NA | 1 (ref) |
| Acute coronary syndrome† | |||||
| Hypertension | 372 | 4·2 (3·8–4·7) | 2·19 (1·95–2·46) | 2·06 (1·83–2·32) | 2·13 (1·86–2·44) |
| No hypertension | 1140 | 2·1 (1·9–2·2) | 1 (ref) | 1 (ref) | 1 (ref) |
| QRISK2 ≥10% | 613 | 7·0 (6·5–7·6) | 4·42 (3·98–4·89) | NA | 4·37 (3·93–4·86) |
| QRISK2 <10% | 899 | 1·6 (1·5–1·7) | 1 (ref) | NA | 1 (ref) |
| Heart failure | |||||
| Hypertension | 290 | 3·3 (2·9–3·7) | 2·04 (1·79–2·32) | 1·92 (1·69–2·19) | 2·08 (1·79–2·42) |
| No hypertension | 961 | 1·7 (1·6–1·9) | 1 (ref) | 1 (ref) | 1 (ref) |
| QRISK2 ≥10% | 478 | 5·5 (5·0–6·0) | 4·00 (3·57–4·49) | NA | 3·85 (3·42–4·34) |
| QRISK2 <10% | 773 | 1·4 (1·3–1·5) | 1 (ref) | NA | 1 (ref) |
| Acute limb ischaemia | |||||
| Hypertension | 25 | 0·3 (0·2–0·4) | 2·98 (1·85–4·78) | 2·82 (1·74–4·55) | 4·63 (2·68–7·99) |
| No hypertension | 55 | 0·1 (0·1–0·1) | 1 (ref) | 1 (ref) | 1 (ref) |
| QRISK2 ≥10% | 42 | 0·5 (0·4–0·7) | 7·55 (4·62–11·07) | NA | 6·93 (4·43–10·83) |
| QRISK2 <10% | 38 | 0·1 (0·1–0·1) | 1 (ref) | NA | 1 (ref) |
| Stroke or transient ischaemic attack‡ | |||||
| Hypertension | 360 | 4·1 (3·7–4·6) | 2·15 (1·91–2·42) | 2·08 (1·84–2·34) | 2·01 (1·75–2·29) |
| No hypertension | 1120 | 2·0 (1·9–2·1) | 1 (ref) | 1 (ref) | 1 (ref) |
| QRISK2 ≥10% | 468 | 5·4 (4·9–5·9) | 2·99 (2·68–3·34) | NA | 2·93 (2·62–3·28) |
| QRISK2 <10% | 1012 | 1·8 (1·7–1·9) | 1 (ref) | NA | 1 (ref) |
| Cardiovascular-related death | |||||
| Hypertension | 129 | 1·5 (1·2–1·8) | 2·11 (1·73–2·58) | 1·99 (1·63–2·43) | 2·15 (1·69–2·73) |
| No hypertension | 413 | 0·7 (0·7–0·8) | 1 (ref) | 1 (ref) | 1 (ref) |
| QRISK2 ≥10% | 230 | 2·6 (2·3–3·0) | 4·77 (4·03–5·66) | NA | 4·81 (3·99–5·81) |
| QRISK2 <10% | 312 | 0·6 (0·5–0·6) | 1 (ref) | NA | 1 (ref) |
Total person-years per 1000 years of follow-up available was 87·9 for hypertension, 553·6 for no hypertension, 87·0 for a QRISK2 score of 10% or higher, and 554·4 for a QRISK2 score of less than 10%. Likelihood ratio test p values for all comparisons were less than 0·0001. HR=hazard ratio. NA=not applicable.
Hypertension models were adjusted for age, sex, race or ethnicity, socioeconomic status, body-mass index, alcohol consumption, and smoking status; QRISK2 models were adjusted for alcohol consumption.
Fully adjusted HR for myocardial infarction alone was 2·22 (95% CI 1·91–2·59) in the hypertension model and 4·89 (4·35–5·51) in the QRISK2 model; fully adjusted HR for angina alone was 2·03 (1·51–2·72) in the hypertension model and 3·06 (2·38–3·93) in the QRISK2 model.
Fully adjusted HR for stroke was 2·10 (95% CI 1·81–2·43) in the hypertension model and 2·90 (2·56–3·30) in the QRISK2 model; and fully adjusted HR for transient ischaemic stroke alone was 1·77 (1·34–2·33) in the hypertension model and 3·10 (2·46–3·90) in the QRISK2 model.