Effect of <i>Helicobacter pylori</i> Treatment on Long-term Mortality in Patients with Hypertension.

<b>Background/Aims:</b> A meta-analysis of randomized trials performed in healthy asymptomatic individuals suggested that overall mortality may increase after <i>Helicobacter pylori</i> eradication despite a significant decrease in the gastric cancer incidence and mortality rates. This retrospective population-based cohort study investigated if <i>H. pylori</i> treatment is associated with an increase in overall mortality in patients with hypertension. <b>Methods:</b> From the database of the Korean National Health Insurance Sample Cohort, we selected 198,487 patients treated for hypertension between 2002 and 2010. Those who received <i>H. pylori</i> treatment (<i>H. pylori</i> treatment cohort, 5,541 patients) were matched to those who did not (nontreatment cohort, 11,082 patients) at the ratio of 1 to 2. The primary outcome was the risk of overall mortality. The secondary outcomes were the risks of mortality due to cardiovascular disease, cerebrovascular disease, and cancer. The outcomes were evaluated from 6 months after <i>H. pylori</i> treatment to December 2013. A Cox proportional hazard model was used to estimate the hazard ratios (HRs). <b>Results:</b> During a median follow-up period of 4.8 years, death from any cause was reported in 4.1% of the patients in the <i>H. pylori</i> treatment cohort and 5.5% of the patients in the nontreatment cohort. The adjusted HR (aHR) for overall mortality in the <i>H. pylori</i> 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 nontreatment cohort, the <i>H. pylori</i> 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 were not different between the cohorts. <b>Conclusions:</b> <i>H. pylori</i> treatment is not associated with an increase in overall mortality in patients treated for hypertension.