Why the study?
Hypertension and diabetes are known risk factors for cardiac and cerebrovascular events, but the relationship between their combination and these events had not been certified.
Does the combination of hypertension and diabetes increase the risk of cardiac and cerebrovascular events compared to either condition alone or neither?
Does the combination of hypertension and diabetes increase the risk of cardiac and cerebrovascular events compared to either condition alone or neither?
Answers are grounded in this paper and cite their sources.
The combination of hypertension and diabetes, whether present at baseline or developing during follow-up, synergistically increases the risk of cardiac and cerebrovascular events.
Background Hypertension and diabetes are both risk factors of cardiac and cerebrovascular events (CCVEs), but the combination of those two factors had not been certified the relationships relevant to CCVEs. The objective of this study is to determine the relationships of hypertension, diabetes and CCVEs.Methods 78380 participants from Kailuan cohort had been analyzed. Baseline information was collected in the health exam and all the participants were regularly followed-up for every two years during 8.96 ± 0.75 years. Participants were divided into six groups according to their hypertension and diabetes status (normal, baseline or follow-up). The incidence of new-onset cerebral ischemic stroke (CI), stroke and CCVEs were respectively calculated. Multiple Cox Regression and Cum Hazard were performed to analyze the hazard ratio for risk of new-onset CI, stroke and CCVEs in each group adjusting for traditional cardiovascular risk markers.Results In total, 78380 participants (including 61950 men) with a mean age of 56.74 at baseline were enrolled in this study. During about 9 years of follow-up, 3734 CCVEs, 2972 stroke and 2340 CI occurred among all the patients, with the incidence density (Per 1,000 years) of 5.29, 4.07 and 3.32. In patients with baseline hypertension and diabetes, hazard ratios (HRs) and 95% confidence intervals (95%CIs) of new-onset CI (HR = 2.45, 95%CI: 1.93, 3.11), stroke (HR = 2.39, 95%CI: 1.92, 2.98) and CCVEs (HR = 2.08, 95% CI: 1.72, 2.52)were higher than the other groups ( P < 0.001). Patients with baseline hypertension or diabetes and follow-up diabetes or hypertension had higher risk of CI, stroke and CCVEs than those who with baseline disease only.Conclusion Hypertension and diabetes alone, especially the combination of these two diseases at baseline and during follow up, contributed significantly to increased risk of new-onset CI, stroke and CCVEs during the 9 years follow up in this cohort.
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Li et al. (2020) studied this question.
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