The risk of infective endocarditis according to blood pressure in patients with diabetes: a nationwide population-based study.

IF 2.6 Q2 PERIPHERAL VASCULAR DISEASE

Clinical Hypertension Pub Date : 2024-12-01 DOI:10.1186/s40885-024-00295-4

Won Kyung Pyo, Hee-Jung Kim, Kyungdo Han, Jin Nam Kim, Se Ju Lee, Jung Ho Kim, Nam Su Ku, Seung Hyun Lee

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Abstract

Background: We aimed to assess the incidence of infective endocarditis (IE) and evaluate the impact of hypertension (HTN) with underweight on the risk of IE among patients with diabetic mellitus (DM) using a nationwide population-based cohort in Korea.

Methods: We identified 2,603,012 participants (57.4 ± 12.3 years) in the national health insurance database. Of these, 374,586 were normotensive, 750,006 were at pre-HTN status, and the remainder had HTN. The risk of IE was compared between the groups, and the impact of being underweight (body mass index < 18.5) was also evaluated.

Results: During follow-up (7.14 years; interquartile range 6.01-8.08 years), 1,703 cases of IE occurred; 168 (0.0647 person per 1000 person-years [PY]), 303 (0.05836 per 1000 PY), and 1,232 (0.12235 per 1000 PY) in normotensive, pre-HTN and HTN group, respectively. Hypertensive participants presented a higher risk of IE (subdistribution hazard ratio, 1.360; 95% confidence interval, 1.152-1.607) than normotensive participants. Being underweight increased the risk of IE by 90% among subjects with HTN. In subgroup analysis, age, duration of DM, insulin use, and habitual factors were not associated with the incidence of IE.

Conclusions: Diabetic patients may require rigorous blood pressure control and simultaneous avoidance of excessive weight loss to prevent IE.

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糖尿病患者血压对感染性心内膜炎风险的影响：一项基于全国人群的研究

背景：我们的目的是评估感染性心内膜炎（IE）的发生率，并评估高血压（HTN）伴体重不足对糖尿病（DM）患者发生IE风险的影响。方法：我们从国家健康保险数据库中确定了2,603,012名参与者（57.4±12.3岁）。其中374,586人血压正常，750,000人处于HTN前状态，其余为HTN。比较两组之间IE的风险，以及体重不足对体重指数（bmi）的影响。四分位数区间6.01 ~ 8.08年)，发生IE 1703例；正常血压组、预HTN组和HTN组分别为168例（0.0647人/ 1000人年[PY]）、303例（0.05836人/ 1000 PY）和1232例（0.12235人/ 1000 PY）。高血压患者发生IE的风险更高(亚分布风险比，1.360；95%可信区间，1.152-1.607)。体重过轻会使HTN患者患IE的风险增加90%。在亚组分析中，年龄、糖尿病病程、胰岛素使用和习惯因素与IE发病率无关。结论：糖尿病患者可能需要严格控制血压，同时避免过度减肥以预防IE。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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