Diabetic population mortality and cardiovascular risk attributable to hypertension: A decade follow-up from the Tehran Lipid and Glucose Study
Diabetic population mortality and cardiovascular risk attributable to hypertension: A decade follow-up from the Tehran Lipid and Glucose Study
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DOI：
10.3109/08037051.2013.769294
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发表时间：
2013-10-01
期刊：
影响因子：
1.8
通讯作者：
Azizi, Fereidoun
中科院分区：
文献类型：
--
作者：
Bozorgmanesh, Mohammadreza;Hadaegh, Farzad;Azizi, Fereidoun
确定糖尿病人群中心血管疾病（CVD）结局的负担在多大程度上归因于高血压。对7068名年龄≥ 20岁的参与者进行了9年的随访，基线时没有CVD。采用考克斯比例风险回归分析方法估计高血压的危险比。人群归因危险分数（PAHF）用于评估糖尿病人群中CVD事件的比例和高血压所致死亡率。在整个人群中，无论是否患有糖尿病或高血压，CVD、冠心病（CHD）以及CVD和全因死亡率的发病率（95%CI）分别为8.3（7.6-9.0）/1000人年、7.1（6.5-7.8）/1000人年、1.8（1.5-2.1）/1000人年和3.9（3.5-4.5）/1000人年。在糖尿病参与者中，高血压是CHD（HR = 1.63，95%CI 1.15-2.03）、CVD（HR = 1.74，95%CI 1.50-2.41）、CVD死亡率（HR = 1.65，95%CI 0.87-3.12）和全因死亡率（HR = 1.53，95%CI 0.97-2.42）的危险因素。然而，全因或CVD死亡率的HR无统计学显著性。CHD、CVD、CVD死亡率和全因死亡率的高血压PAHF（%）分别为27.5（95% CI 8.3-42.6）、29.6（95% CI 10.6-44.4）、27.9（95% CI = 17.2 - 55.7）和22.6（95% CI = 5.9 - 43.4）。我们的研究表明，高血压合并糖尿病患者发生心血管疾病的风险过高，与血压控制不足有关。
To determine the extent to which burden of cardiovascular disease (CVD) outcomes among diabetic population is attributable to hypertension. Nine-year follow-up data were secured for 7068 participants aged >= 20 years old, free from CVD at baseline. Cox proportional hazards regression was implemented to estimate hazard ratios (HRs) of hypertension. Population-attributable hazard fraction (PAHF) was used to assess proportion of diabetic population hazard of CVD events and mortality attributable to hypertension. In the whole population, irrespective of diabetes or hypertension status, incidence rate (95% CI) of CVD, coronary heart disease (CHD), as well as CVD and all-cause mortality per 1000 person-year were 8.3 (7.6-9.0), 7.1 (6.5-7.8), 1.8 (1.5-2.1) and 3.9 (3.5-4.5), respectively. Among diabetes participants, hypertension was a risk factor for CHD (HR = 1.63, 95% CI 1.15-2.03), CVD (HR = 1.74, 95% CI 1.50-2.41), CVD mortality (HR = 1.65, 95% CI 0.87-3.12) and all-cause mortality (HR = 1.53, 95% CI 0.97-2.42). HRs, however, were not statistically significant for all-cause or CVD mortality. PAHFs (%) of hypertension was 27.5 (95% CI 8.3-42.6) for CHD, 29.6 (95% CI 10.6-44.4) for CVD, 27.9 (95% CI = 17.2 to 55.7) for CVD mortality and 22.6 (95% CI = 5.9 to 43.4) for all-cause mortality. Our study shows that there is an excess risk of CVD in hypertensive patients with diabetes related to inadequate control of blood pressure.