Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Dec 21:9:98.
doi: 10.1186/s13098-017-0296-z. eCollection 2017.

Hypertensive diabetic patients: incidence of cardiovascular and renal outcomes in a historical cohort over 11 years

Andréa Cristina Sousa  1   2 , Thiago Veiga Jardim  1   2 , Thiago Olivera Costa  1 , Fabrício Galdino Magalhães  1   2 , Marcos Paulo Marinho Montelo  1 , Weimar K Barroso Souza  1   2 , Paulo César Brandão Veiga Jardim  1   2 , Ana Luiza Lima Sousa  3   1
Affiliations

Hypertensive diabetic patients: incidence of cardiovascular and renal outcomes in a historical cohort over 11 years

Andréa Cristina Sousa et al. Diabetol Metab Syndr. .

Abstract

Background: Diabetics have increased risks for cardiovascular disease (CVD) and mortality, reducing their life expectancy by up to 15 years. Type 2 diabetes mellitus specifically increases the risk for cardiovascular mortality nearly fivefold. When hypertension is combined with diabetes, the risk of CVD is even greater.

Objective: Identify non-fatal cardiovascular outcomes and renal function impairment in a cohort of hypertensive patients in regular treatment in a reference treatment center, over 11 years of follow-up.

Methods: Historical cohort of hypertensive patients in regular treatment for at least 11 years in a specialized service for hypertension treatment. The exposed group was hypertensive diabetic patients at the beginning of the cohort, and the non-exposed group had hypertension without diabetes. The cohort began in 2004, with follow-ups in 2009 and 2015. Variables used: gender, race, age, physical activity, alcohol consumption, smoking, blood pressure, body mass index, glycated hemoglobin, diabetes and hypertension diagnosis times, treatment time in specialized service, non-fatal cardiovascular outcomes, and renal impairment assessed by creatinine clearance.

Results: 139 patients participated in the study (55 diabetic hypertensive; 84 non-diabetic hypertensive), with an initial (2004) mean hypertension treatment time of 5.8 years. Females were the majority (75.5%) in both groups. Groups were similar regarding socio-demographic variables, but the group of hypertensive diabetic patients had higher frequency of obesity and uncontrolled BP, which persisted in all follow-ups. In 11 years of follow-up (2004-2015), the diabetic group had more cardiovascular events, with increased risk of acute myocardial infarction (RR 95% CI 1.6 12.2-95.0), stroke (RR 95% CI 1.3-6.1 27.7) and complications requiring hospitalization (RR 95% CI 1.6 2.2-3.0). Worsened renal function occurred more often in the non-exposed group, but in the end, the proportion of renal function loss was similar between groups.

Conclusions: Exposure to type 2 diabetes increased the risk of new cardiovascular outcomes over 11 years of follow-up of hypertensive patients. Diabetes by itself increased the risk of cardiovascular outcomes, justifying more intensive actions in this population.

Keywords: Cardiovascular diseases; Diabetes complication; Hypertension; Type 2 diabetes mellitus.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Cohort inclusion flow chart
Fig. 2
Fig. 2
Distribution of patients with different categories of renal function throughout the study period (2004–2015), Goiânia, GO, Brazil, 2004–2015. McNemar–Browker test: *p < 0.05
See this image and copyright information in PMC

References

    1. Pechere-Bertschi A, Greminger P, Hess L, Philippe J, Ferrari P. Swiss hypertension and risk factor program (SHARP): cardiovascular risk factors management in patients with type 2 diabetes in Switzerland. Blood Press. 2005;14(6):337–344. doi: 10.1080/08037050500340018. - DOI - PubMed
    1. Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, et al. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999;100(10):1134–1146. doi: 10.1161/01.CIR.100.10.1134. - DOI - PubMed
    1. Mannucci E, Dicembrini I, Lauria A, Pozzilli P. Is glucose control important for prevention of cardiovascular disease in diabetes? Diabetes Care. 2013;36(Suppl 2):S259–S263. doi: 10.2337/dcS13-2018. - DOI - PMC - PubMed
    1. Juutilainen A, Lehto S, Ronnemaa T, Pyorala K, Laakso M. Similarity of the impact of type 1 and type 2 diabetes on cardiovascular mortality in middle-aged subjects. Diabetes Care. 2008;31(4):714–719. doi: 10.2337/dc07-2124. - DOI - PubMed
    1. Savoia C, Schiffrin EL. Vascular inflammation in hypertension and diabetes: molecular mechanisms and therapeutic interventions. Clin Sci. 2007;112(7):375–384. doi: 10.1042/CS20060247. - DOI - PubMed

LinkOut - more resources