What is the clinical evidence from this study?

Study design: Cohort. Population: diabetes (n=16553). Intervention: Hypertension vs. participants without hypertension. Primary outcome: CHD mortality (HR 1.24, 95% CI 1.07-1.42).

What does this research mean for the field?

Among persons with diabetes, hypertension increases the risk of cardiovascular disease mortality similarly across racial groups, despite baseline racial differences in the risk of specific cardiovascular outcomes. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research examines how hypertension influences cardiovascular disease (CVD) mortality in individuals with diabetes, focusing on variations by CVD type and race.

June 7, 2026

1416-P: Relationship of Hypertension with CVD Mortality Varies by CVD Type but Not Race in Persons with Diabetes

Key Result

In persons with diabetes, hypertension increased the risk of CHD mortality (HR 1.24; 95% CI 1.07-1.42), heart failure, and stroke mortality, with no significant interaction by race.

Key Points

This research examines how hypertension influences cardiovascular disease (CVD) mortality in individuals with diabetes, focusing on variations by CVD type and race.
Conducted a follow-up mortality analysis of 16,553 participants aged 40-79 with diabetes, predominantly African American and White.
Performed multivariable competing risk Cox analyses to calculate hazard ratios for CVD and other mortality outcomes over a mean follow-up of 13.4 years.
Hypertension increased coronary heart disease mortality (HR=1.24, 95% CI=1.07-1.42) and stroke mortality (HR=1.43, 95% CI=1.16-1.75).
Lower risk of coronary heart disease mortality found in African Americans (HR=0.67, 95% CI=0.60-0.75) compared to White Americans, but increased risk for stroke mortality (HR=1.35, 95% CI=1.12-1.62).
Hypertension's relationship with CVD mortality outcomes did not differ by race (p-interaction all >0.10).

Study Design

Type

Cohort (n=16,553)

Structured PICO

Does hypertension increase the risk of specific cardiovascular disease mortality outcomes in persons with diabetes, and does this vary by race?

Population

16,553 mostly low-income participants aged 40-79 with diabetes, predominantly African American and White, followed for a mean of 13.4 years.

Exposure

Hypertension

Comparator

Participants without hypertension

Outcome

CVD mortality outcomes (coronary heart disease, heart failure, and stroke) and all other mortalityhard clinical

In persons with diabetes, hypertension significantly increases the risk of mortality from coronary heart disease, heart failure, and stroke, and this increased risk is consistent across racial groups.

Main Result

Hazard Ratio: 1.24 (95% CI 1.07–1.42)

Abstract

Introduction and Objective: Diabetes and hypertension are increased among African Americans as is the risk of cardiovascular disease (CVD) mortality, though this may vary by type of CVD. We investigated the relationship between hypertension and CVD mortality outcomes, namely coronary heart disease (CHD), heart failure and stroke among persons w/ diabetes and whether risk varied by race for type of CVD mortality. Methods: We conducted a mortality follow up of a cohort of 16,553 mostly low income predominately African American and White participants aged 40-79 w/ diabetes (African American n=11,335; White American n=4,518, Other races n=700) at cohort entry. Multivariable competing risk Cox analyses were conducted to obtain Hazard Ratios with 95% CI for CVD mortality outcomes and all other mortality. Results: Mean age and diabetes duration were 55 and 10 years, respectively. After a mean of 13.4 years of followup, there were 8661 deaths (53% of the population). In multivariable adjusted analysis, HRs (95% CIs) for hypertension were: CHD mortality (HR = 1.24 95% CI = 1.07 - 1.42), heart failure mortality (HR = 1.39 95% CI =1.17 - 1.65), stroke mortality (HR = 1.43 95% CI = 1.16 - 1.75), and All Other Mortality (HR = 1.20 95% CI = 1.11 - 1.30) compared to participants without hypertension. African Americans (HR=0.67, 0.60-0.75) and other races (0.83, 0.65-1.06) were at a lower risk of CHD, an increased risk of stroke mortality (African Americans HR: 1.35, 1.12-1.62; other races: 1.27, 0.86-1.89) and no increased risk of heart failure mortality (African Americans: HR=0.98, 0.86-1.12: Other races: HR=1.09: 0.82-1.44) compared to non-Hispanic White American participants, however, the association of hypertension with each of the CVD mortality outcomes did not vary by race (p-interaction all0.10). Conclusion: Although the relationship of race with risk of CVD mortality varied by type of CVD, the relationship of hypertension with these mortality outcomes did not vary by race. Our data suggests that hypertension affects CVD mortality outcomes similarly across races. Disclosure R. Chauma: None. R. Conway: None. Funding National Institutes of Health (U01CA202979) and Vanderbilt-Ingram Cancer Center (P30 CA68485).

KI fragen

Bookmark