Early-Onset Hypertension and Sex-Specific Residual Risk for Cardiovascular Disease in Type 2 Diabetes

IF 14.8 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Diabetes Care Pub Date : 2024-04-24 DOI:10.2337/dc23-2275
Hongwei Ji, Joseph E. Ebinger, Alan C. Kwan, Karen Reue, Jennifer C. Sullivan, John Shyy, Susan Cheng
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Abstract

OBJECTIVE To investigate whether the sex disparities in type 2 diabetes–associated cardiovascular disease (CVD) risks may be related to early-onset hypertension that could benefit from intensive blood pressure (BP) control. RESEARCH DESIGN AND METHODS We analyzed intensive versus standard BP control in relation to incident CVD events in women and men with type 2 diabetes, based on their age of hypertension diagnosis. RESULTS Among 3,792 adults with type 2 diabetes (49% women), multivariable-adjusted CVD risk was increased per decade earlier age at hypertension diagnosis (hazard ratio 1.11 [1.03–1.21], P = 0.006). Excess risk associated with early-diagnosed hypertension was attenuated in the presence of intensive versus standard antihypertensive therapy in women (P = 0.036) but not men (P = 0.76). CONCLUSIONS Women with type 2 diabetes and early-onset hypertension may represent a higher-risk subpopulation that not only contributes to the female excess in diabetes-related CVD risk but may benefit from intensive BP control.
早发高血压与 2 型糖尿病心血管疾病的性别特异性残余风险
目的 探讨 2 型糖尿病相关心血管疾病(CVD)风险的性别差异是否可能与早期高血压有关,而早期高血压可从强化血压(BP)控制中获益。研究设计与方法 我们根据 2 型糖尿病患者的高血压诊断年龄,分析了强化血压控制与标准血压控制在女性和男性 2 型糖尿病患者心血管疾病事件中的关系。结果 在 3,792 名 2 型糖尿病成人患者中(49% 为女性),高血压诊断年龄每提前十年,经多变量调整后的心血管疾病风险就会增加(危险比 1.11 [1.03-1.21],P = 0.006)。与早期诊断的高血压相关的过高风险在女性接受强化降压治疗与标准降压治疗的情况下有所降低(P = 0.036),而男性则没有降低(P = 0.76)。结论 患有 2 型糖尿病和早发性高血压的女性可能是高风险亚群,她们不仅导致女性糖尿病相关心血管疾病风险过高,而且可能从强化血压控制中获益。
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来源期刊
Diabetes Care
Diabetes Care 医学-内分泌学与代谢
CiteScore
27.80
自引率
4.90%
发文量
449
审稿时长
1 months
期刊介绍: The journal's overarching mission can be captured by the simple word "Care," reflecting its commitment to enhancing patient well-being. Diabetes Care aims to support better patient care by addressing the comprehensive needs of healthcare professionals dedicated to managing diabetes. Diabetes Care serves as a valuable resource for healthcare practitioners, aiming to advance knowledge, foster research, and improve diabetes management. The journal publishes original research across various categories, including Clinical Care, Education, Nutrition, Psychosocial Research, Epidemiology, Health Services Research, Emerging Treatments and Technologies, Pathophysiology, Complications, and Cardiovascular and Metabolic Risk. Additionally, Diabetes Care features ADA statements, consensus reports, review articles, letters to the editor, and health/medical news, appealing to a diverse audience of physicians, researchers, psychologists, educators, and other healthcare professionals.
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