Background High blood pressure (BP) is a major risk factor for cardiovascular disease (CVD). Adequate treatment of high BP should reduce the risk of CVD, but this association has seldom been assessed in a general population setting. Methods Population-based prospective study conducted in Lausanne, Switzerland, with a follow-up between 2003 and 2021. Participants were categorised as normal BP, untreated high BP, treated and uncontrolled BP and treated and controlled BP. Total and CVD mortality as well as any CVD event were assessed. Results 5341 participants (65% normal, 17.4% untreated, 8.8% treated and uncontrolled and 8.8% treated and controlled) were included. After a median follow-up of 14 years (IQR: 11–15), 575 CVD events occurred. Relative to participants with normal BP, multivariable-adjusted HRs (and 95% CI) for total CVD were 1.38 (1.11 to 1.72) for untreated, 1.35 (1.04 to 1.76) for treated and uncontrolled and 1.50 (1.15 to 1.95) for treated and controlled. The corresponding HRs for CVD mortality (112 events) were 0.94 (0.52 to 1.70), 1.77 (1.00 to 3.12) and 2.52 (1.50 to 4.23), respectively. For total mortality (677 events), the HRs were 1.24 (1.01 to 1.52), 1.26 (0.99 to 1.60) and 1.27 (0.99 to 1.62), respectively. Sensitivity analysis using BP status during a 5-year period and categorising participants as always normal, always treated and uncontrolled, always treated and controlled and other led to similar findings. Conclusion Over a long follow-up period of 14 years, BP control was not associated with reduction of CVD events, CVD-related or total mortality. This finding should help define further studies on factors affecting CVD and mortality in people treated for hypertension in the general population. Data are available upon reasonable request. The data of CoLaus|PsyCoLaus study used in this article cannot be fully shared as they contain potentially sensitive personal information on participants. According to the Ethics Committee for Research of the Canton of Vaud, sharing these data would be a violation of the Swiss legislation with respect to privacy protection. However, coded individual-level data that do not allow researchers to identify participants are available upon request to researchers who meet the criteria for data sharing of the CoLaus|PsyCoLaus Datacenter (CHUV, Lausanne, Switzerland). Any researcher affiliated to a public or private research institution who complies with the CoLaus|PsyCoLaus standards can submit a research application to research.colaus@chuv.ch or research.psycolaus@chuv.ch. Proposals requiring baseline data only will be evaluated by the baseline (local) Scientific Committee (SC) of the CoLaus and PsyCoLaus studies. Proposals requiring follow-up data will be evaluated by the follow-up (multicentric) SC of the CoLaus|PsyCoLaus cohort study. Detailed instructions for gaining access to the CoLaus|PsyCoLaus data used in this study are available at [www.colaus-psycolaus.ch/professionals/how-to-collaborate/][1]. [1]: http://www.colaus-psycolaus.ch/professionals/how-to-collaborate/

中文翻译：

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血压状态、轨迹和心血管疾病：CoLaus|PsyCoLaus 前瞻性研究

背景 高血压（BP）是心血管疾病（CVD）的主要危险因素。高血压的充分治疗应该可以降低心血管疾病的风险，但这种关联很少在一般人群中进行评估。方法 在瑞士洛桑进行基于人群的前瞻性研究，并于 2003 年至 2021 年间进行随访。参与者被分为正常血压、未治疗的高血压、已治疗且未控制的血压以及已治疗和控制的血压。评估了总死亡率和CVD死亡率以及任何CVD事件。结果 5341 名参与者（65% 正常，17.4% 未治疗，8.8% 治疗但未控制，8.8% 治疗和控制）被纳入。中位随访 14 年（IQR：11-15）后，发生了 575 起 CVD 事件。相对于血压正常的参与者，未治疗的总 CVD 的多变量调整 HR（95% CI）为 1.38（1.11 至 1.72），治疗和未控制的为 1.35（1.04 至 1.76），治疗和未控制的为 1.50（1.15 至 1.95）。受控。CVD死亡率（112个事件）的相应HR分别为0.94（0.52至1.70）、1.77（1.00至3.12）和2.52（1.50至4.23）。对于总死亡率（677 起事件），HR 分别为 1.24（1.01 至 1.52）、1.26（0.99 至 1.60）和 1.27（0.99 至 1.62）。使用 5 年期间的血压状况进行敏感性分析，并将参与者分类为始终正常、始终接受治疗且不受控制、始终接受治疗且控制等，得出了类似的结果。结论 经过 14 年的长期随访，血压控制与 CVD 事件、CVD 相关死亡率或总死亡率的减少无关。这一发现应该有助于进一步研究影响普通人群高血压治疗者心血管疾病和死亡率的因素。数据可根据合理要求提供。本文中使用的 CoLaus|PsyCoLaus 研究数据无法完全共享，因为它们包含参与者的潜在敏感个人信息。沃州研究伦理委员会表示，共享这些数据将违反瑞士有关隐私保护的立法。然而，符合 CoLaus|PsyCoLaus 数据中心（瑞士洛桑 CHUV）数据共享标准的研究人员可以根据要求获得不允许研究人员识别参与者的编码个人数据。任何隶属于公共或私人研究机构且符合 CoLaus|PsyCoLaus 标准的研究人员都可以向 Research.colaus@chuv.ch 或 Research.psycolaus@chuv.ch 提交研究申请。仅需要基线数据的提案将由 CoLaus 和 PsyCoLaus 研究的基线（当地）科学委员会 (SC) 进行评估。需要后续数据的提案将由 CoLaus|PsyCoLaus 队列研究的后续（多中心）SC 进行评估。有关获取本研究中使用的 CoLaus|PsyCoLaus 数据的详细说明，请访问 [www.colaus-psycolaus. ch/professionals/how-to-collaborate/][1]。[1]：http://www.colaus-psycolaus.ch/professionals/how-to-collaborate/