Adverse prognostic significance of new diabetes in treated hypertensive subjects
| Autor: | Carlo Porcellati, Fabio Angeli, Lucia Filippucci, Claudia Borgioni, Gianpaolo Reboldi, Roberto Gattobigio, Paolo Verdecchia, Silvia Norgiolini, Costanza Bracco |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Risk medicine.medical_specialty Ambulatory blood pressure Adrenergic beta-Antagonists Type 2 diabetes Disease-Free Survival Cohort Studies Electrocardiography Internal medicine Diabetes mellitus Internal Medicine medicine risk factors Humans Life Tables Risk factor Diuretics Antihypertensive Agents Proportional Hazards Models hypertension diabetes Prognosis business.industry Incidence Smoking Blood Pressure Monitoring Ambulatory Middle Aged medicine.disease Lipids Surgery Blood pressure Diabetes Mellitus Type 2 Cardiovascular Diseases Relative risk Ambulatory Hypertension Female Hypertrophy Left Ventricular business Cohort study Follow-Up Studies |
| Zdroj: | Hypertension (Dallas, Tex. : 1979). 43(5) |
| ISSN: | 1524-4563 |
| Popis: | Diabetes may develop in nondiabetic hypertensive subjects during treatment, but the long-term cardiovascular implications of this phenomenon are not clear. We determined the prognostic value of new diabetes in hypertensive subjects. In a long-term cohort study, 795 initially untreated hypertensive subjects, 6.5% of whom with type 2 diabetes, underwent diagnostic procedures including 24-hour ambulatory blood pressure (BP) monitoring and electrocardiography (ECG). Procedures were repeated after a median of 3.1 years in the absence of cardiovascular events. Follow-up duration was 1 to 16 years (median 6.0). New diabetes occurred in 5.8% of subjects initially without diabetes. Antihypertensive treatment included a diuretic in 53.5% of these subjects, versus 30.4% of those in whom diabetes did not develop ( P =0.002). Plasma glucose at entry ( P =0.0001) and diuretic treatment on follow-up ( P =0.004) were independent predictors of new diabetes. Subsequent to the follow-up visit, a first cardiovascular event occurred in 63 subjects. Event rate in nondiabetic subjects at both visits, new diabetes, and diabetes at entry were 0.97, 3.90, and 4.70×100 person-years, respectively ( P =0.0001). After adjustment for several confounders, including 24-hour ambulatory BP, the relative risk of events was 2.92 (95% CI: 1.33 to 6.41; P =0.007) in the group with new diabetes and 3.57 (95% CI: 1.65 to 7.73; P =0.001) in the group with previous diabetes, when compared with the group persistently free of diabetes. In treated hypertensive subjects, occurrence of new diabetes portends a risk for subsequent cardiovascular disease that is not dissimilar from that of previously known diabetes. |
| Databáze: | OpenAIRE |
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