Co-existing hypertension may explain significant excess CV risk in diabetics
MedWire News: Co-existing hypertension may explain a significant amount of the excess cardiovascular (CV) risk experienced by patients with diabetes, suggest study findings.
Patients with diabetes have high CV risk compared with the general population, but whether this surplus risk is due to co-existing CV disease or diabetes alone is less clear.
In this study, Finlay McAlister (University of Alberta, Canada) and colleagues retrospectively evaluated data for 1145 patients from the Framingham original and offspring studies with newly diagnosed diabetes and no history of CV events to assess the degree of CV disease and mortality risk attributable to concurrent hypertension (n=663; 58%).
Over a total of 4145 person-years of follow-up, 125 patients died and 204 had a CV event (myocardial infarction, heart failure, stroke).
McAlister and team report that rates of all-cause mortality and CV events were higher in patients with co-existing hypertension than in those without, at 32 versus 20 per 1000 person-years and 52 versus 31 per 1000 person-years, respectively.
Following adjustment for various demographic and clinical risk factors, presence of hypertension at baseline or during follow-up increased the all-cause mortality and CV event risk in patients with diabetes by 72% and 57%, respectively.
The researchers estimated that the population-attributable risk for all-cause death and CV events from hypertension in patients with diabetes was a respective 30% and 25%, whereas the population-attributable risk for these outcomes from diabetes (adjusted for hypertension) was a significantly lower 7% and 9%, respectively.
"Although diabetes mellitus is associated with increased risks for death and CV events in the Framingham cohort, we have established that much of this excess risk is attributable to co-existent hypertension in diabetic individuals," write the authors in the journal Hypertension.
"Increased attention to the role of blood pressure control in preventing CV events in individuals with diabetes mellitus is essential," they emphasize.
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By Helen Albert