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Volume 21, Issue 9
  • ISSN: 1573-3998
  • E-ISSN: 1875-6417

Abstract

Introduction

Patients with hypertension and diabetes are more susceptible to cardiovascular diseases (CVD) and mortality. This study aimed to evaluate the individual and combined effects of hypertension and diabetes on cardiovascular events and mortality in a Middle Eastern population-based cohort.

Methods

Fifteen-year follow-up data were collected for 6323 adults aged 35 years and older who were free from CVD at baseline. The subjects were categorized into different groups according to hypertension and diabetes at baseline. Cox proportional hazards regression was implemented to estimate hazard ratios (HRs) of hypertension and diabetes for cardiovascular events (CVE), CVD mortality, and all-cause mortality. Population-attributable hazard fraction (PAHF) was used to assess the proportion of hazards of CVE and mortality attributable to hypertension or diabetes.

Results

The incidence rates (95% CI) of CVE, CVE mortality, and all-cause mortality in the total population were 13.77(12.84-14.77), 3.01(2.59-3.49), and 9.92(9.15-10.77) per 1000 persons per year respectively. The HR of hypertension for CVE in the diabetic population was 1.98 (1.47-2.66) with a PAHF of 27.65(15.49-39.3). When the HRs and PAHF of diabetes were evaluated in hypertensive patients, they were statistically significant for CVE, CVE mortality, and all-cause mortality.

Conclusion

Our study indicated that the joint effect of diabetes and hypertension is the dramatic increased risk of CVE. A considerable fraction of the excess risk of CVE in patients with diabetes was attributable to hypertension, on the other hand, diabetes was associated with a substantial hazard fraction of CVE and mortality in hypertensive patients.

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2024-08-07
2025-04-21

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References

  1. Turk-AdawiK. SarrafzadeganN. FadhilI. TaubertK. SadeghiM. WengerN.K. TanN.S. GraceS.L. Cardiovascular disease in the Eastern Mediterranean region: epidemiology and risk factor burden.Nat. Rev. Cardiol.201815210611910.1038/nrcardio.2017.13828933782
     [Google Scholar]
  2. Top Causes of Death -- Global Projections of mortality and causes of death, 2015 and 2030.2013Available from: https://knowledge4policy.ec.europa.eu/visualisation/top-causes-death-global-projections-mortality-causes-death-2015-2030_en(accessed on 15-7-2024)
  3. The global burden of disease: 2004 update.World Health Organization2008
     [Google Scholar]
  4. El-AtatF. McFarlaneS.I. SowersJ.R. Diabetes, hypertension, and cardiovascular derangements: Pathophysiology and management.Curr. Hypertens. Rep.20046321522310.1007/s11906‑004‑0072‑y15128475
     [Google Scholar]
  5. SampanisC. ZamboulisC. Arterial hypertension in diabetes mellitus: from theory to clinical practice.Hippokratia2008122748018923653
     [Google Scholar]
  6. SowersJ.R. EpsteinM. FrohlichE.D. Diabetes, hypertension, and cardiovascular disease: an update.Hypertension20013741053105910.1161/01.HYP.37.4.105311304502
     [Google Scholar]
  7. LagoR.M. SinghP.P. NestoR.W. Diabetes and hypertension.Nat. Clin. Pract. Endocrinol. Metab.200731066766810.1038/ncpendmet063817893686
     [Google Scholar]
  8. HolmanR.R. PaulS.K. BethelM.A. NeilH.A.W. MatthewsD.R. Long-term follow-up after tight control of blood pressure in type 2 diabetes.N. Engl. J. Med.2008359151565157610.1056/NEJMoa080635918784091
     [Google Scholar]
  9. SarrafzadeganN. TalaeiM. SadeghiM. KelishadiR. OveisgharanS. MohammadifardN. SajjadiehA.R. KabiriP. MarshallT. ThomasG.N. TavasoliA. The Isfahan cohort study: Rationale, methods and main findings.J. Hum. Hypertens.201125954555310.1038/jhh.2010.9921107436
     [Google Scholar]
  10. ChenG. McAlisterF.A. WalkerR.L. HemmelgarnB.R. CampbellN.R.C. Cardiovascular outcomes in framingham participants with diabetes: the importance of blood pressure.Hypertension201157589189710.1161/HYPERTENSIONAHA.110.16244621403089
     [Google Scholar]
  11. BozorgmaneshM. HadaeghF. MohebiR. GhanbarianA. EskandariF. AziziF. Diabetic population mortality and cardiovascular risk attributable to hypertension: A decade follow-up from the Tehran Lipid and Glucose Study.Blood Press.201322531732410.3109/08037051.2013.76929423458066
     [Google Scholar]
  12. SarrafzadeganN. HassannejadR. RoohafzaH. SadeghiM. TalaeiM. OveisgharanS. MansourianM. A 10-year Isfahan cohort on cardiovascular disease as a master plan for a multi-generation non-communicable disease longitudinal study: methodology and challenges.J. Hum. Hypertens.2019331180781610.1038/s41371‑018‑0126‑230385824
     [Google Scholar]
  13. ChobanianA.V. BakrisG.L. BlackH.R. CushmanW.C. GreenL.A. IzzoJ.L.Jr JonesD.W. MatersonB.J. OparilS. WrightJ.T.Jr RoccellaE.J. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report.JAMA2003289192560257210.1001/jama.289.19.256012748199
     [Google Scholar]
  14. The practical guide: identification, evaluation, and treatment of overweight and obesity in adults.NIH Publication2000
     [Google Scholar]
  15. BraunwaldE. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction--summary article: a report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee on the Management of Patients With Unstable Angina).J Am Coll Cardiol.200240713661374
     [Google Scholar]
  16. HuG. JousilahtiP. TuomilehtoJ. Joint effects of history of hypertension at baseline and type 2 diabetes at baseline and during follow-up on the risk of coronary heart disease.Eur. Heart J.200728243059306610.1093/eurheartj/ehm50117981826
     [Google Scholar]
  17. SarwarN. GaoP. SeshasaiS.R. GobinR. KaptogeS. Di AngelantonioE. IngelssonE. LawlorD.A. SelvinE. StampferM. StehouwerC.D. LewingtonS. PennellsL. ThompsonA. SattarN. WhiteI.R. RayK.K. DaneshJ. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies.Lancet201037597332215222210.1016/S0140‑6736(10)60484‑920609967
     [Google Scholar]
  18. SunkaraN. H AhsanC. Hypertension in diabetes and the risk of cardiovascular disease.Cardiovasc. Endocrinol.201761333810.1097/XCE.000000000000011431646117
     [Google Scholar]
  19. BoussageonR. Bejan-AngoulvantT. Saadatian-ElahiM. LafontS. BergeonneauC. KassaïB. ErpeldingerS. WrightJ.M. GueyffierF. CornuC. Effect of intensive glucose lowering treatment on all cause mortality, cardiovascular death, and microvascular events in type 2 diabetes: meta-analysis of randomised controlled trials.BMJ2011343jul26 1d416910.1136/bmj.d416921791495
     [Google Scholar]
  20. GroupA.S. ACCORD Study Group Nine-year effects of 3.7 years of intensive glycemic control on cardiovascular outcomes.Diabetes Care201639570170810.2337/dc15‑228326822326
     [Google Scholar]
  21. Hamid ZargarA. Iqbal WaniA. Rashid MasoodiS. Ahmad LawayB. Iftikhar BashirM. Mortality in diabetes mellitus—data from a developing region of the world.Diabetes Res. Clin. Pract.1999431677410.1016/S0168‑8227(98)00112‑010199590
     [Google Scholar]
  22. BallotariP. VicentiniM. ManicardiV. GalloM. Chiatamone RanieriS. GreciM. Giorgi RossiP. Diabetes and risk of cancer incidence: results from a population-based cohort study in northern Italy.BMC Cancer201717170310.1186/s12885‑017‑3696‑429070034
     [Google Scholar]
  23. HuG. SartiC. JousilahtiP. PeltonenM. QiaoQ. AntikainenR. TuomilehtoJ. The impact of history of hypertension and type 2 diabetes at baseline on the incidence of stroke and stroke mortality.Stroke200536122538254310.1161/01.STR.0000190894.30964.7516282538
     [Google Scholar]
  24. KokuboY. OkamuraT. WatanabeM. HigashiyamaA. OnoY. MiyamotoY. FurukawaY. KamideK. KawanishiK. OkayamaA. YoshimasaY. The combined impact of blood pressure category and glucose abnormality on the incidence of cardiovascular diseases in a Japanese urban cohort: the Suita Study.Hypertens. Res.201033121238124310.1038/hr.2010.17420927111
     [Google Scholar]
  25. TalaeiM. SadeghiM. MohammadifardN. ShokouhP. OveisgharanS. SarrafzadeganN. Incident hypertension and its predictors.J. Hypertens.2014321303810.1097/HJH.0b013e32836591d424048009
     [Google Scholar]
  26. OhJ.Y. AllisonM.A. Barrett-ConnorE. Different impacts of hypertension and diabetes mellitus on all-cause and cardiovascular mortality in community-dwelling older adults.J. Hypertens.2017351556210.1097/HJH.000000000000114527906837
     [Google Scholar]
/content/journals/cdr/10.2174/0115733998304318240731051957
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Integration of Diabetes Mellitus and Hypertension on Major Cardiovascular Events: An Experience From a 15-year Follow-up Cohort Study in EMR
Curr. Diabetes Rev. 21, e15733998304318 (2025); https://doi.org/10.2174/0115733998304318240731051957
/content/journals/cdr/10.2174/0115733998304318240731051957
/content/journals/cdr/10.2174/0115733998304318240731051957
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  • Article Type:     Research Article
Keyword(s): cardiovascular events; Diabetes Mellitus; hazard ratios; hypertension; mortality; population-attributable hazard fraction

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