Impacts of type 2 diabetes mellitus and hypertension on the incidence of cardiovascular diseases and stroke in China real-world setting: a retrospective cohort study

OBJECTIVE: The prevalence of type 2 diabetes mellitus (T2DM) and hypertension (HTN) has notably increased in recent years. However, there is little evidence from large-scale studies assessing the joint effect of T2DM and HTN on the risk of cardiovascular events in China. This study was performed to investigate the association of T2DM and HTN with the incidence of combined vascular events (VEs) and stroke in China. DESIGN: A retrospective cohort study. SETTING: Data were collected from the SuValue database which includes the electronic medical records of >90 million patients from 161 hospitals across 18 provinces in China. PARTICIPANTS: Patients aged ≥18 with a diagnosis of T2DM and/or HTN were included. Non-T2DM and non-HTN patients were included in this study as controls. OUTCOMES: Incidence of combined VEs and stroke during the study. RESULTS: In the current study, 8012 patients with T2DM, 9653 patients with HTN, 3592 patients with both T2DM and HTN and 10 561 patients without T2DM or HTN were included. T2DM was significantly associated with combined VE and stroke risk (HR 1.332, 95% CI 1.134 to 1.565 and HR 1.584, 95% CI 1.246 to 2.014, respectively). HTN was significantly associated with combined VE and stroke risk (HR 3.244, 95% CI 2.946 to 3.572 and HR 4.543, 95% CI 3.918 to 5.268, respectively). T2DM combined with HTN was significantly associated with combined VE and stroke risk (HR 3.002, 95% CI 2.577 to 3.497 and HR 4.151, 95% CI 3.346 to 5.149, respectively). HTN was associated with a higher combined VE and stroke risk than T2DM (HR 2.435, 95% CI 2.113 to 2.805 and HR 2.868, 95% CI 2.341 to 3.513, respectively). CONCLUSION: T2DM and HTN were strongly associated with combined VE and stroke risk; however, the HTN-only group had a higher combined VE and stroke risk than the T2DM-only group.