Impacts of hypertension and diabetes on the incidence of cardiovascular diseases and all-cause mortality: findings from the China Health and Retirement Longitudinal Study cohort.

IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Journal of Hypertension Pub Date : 2025-04-01 Epub Date: 2024-12-11 DOI:10.1097/HJH.0000000000003946
Qiang Tu, Karice Hyun, Shuanglan Lin, Nashid Hafiz, Deborah Manandi, Emily Li, Xinzheng Wang, Haisheng Wu, Julie Redfern
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Abstract

Objective: The study aimed to examine the individual and joint effects of hypertension and diabetes on cardiovascular diseases and all-cause mortality among the middle-aged and older Chinese population.

Methods: A total of 9681 individuals without preexisting CVD from the China Health and Retirement Longitudinal Study (CHARLS) were included. Participants were classified into four different groups: hypertension alone, diabetes alone, both conditions, neither condition. Multivariate Cox proportional hazards models were performed to estimate the risks of all-cause mortality and CVD.

Results: During the 7-year follow-up, 967 deaths and 1535 CVD events were documented. Compared to individuals without hypertension and diabetes, hypertension alone [adjusted hazard ratio (aHR) 1.571, 95% confidence interval (CI) 1.316-1.875, P  < 0.001], diabetes alone (aHR 1.618, 95% CI 1.187-2.205, P  < 0.01) and comorbid hypertension and diabetes (aHR 2.041, 95% CI 1.557-2.677, P  < 0.001) increased risks of all-cause mortality. The aHRs for CVD events in individuals with both conditions, hypertension alone and diabetes only were 2.011 (95% CI 1.651-2.449, P  < 0.001), 1.408 (95% CI 1.233-1.608, P  < 0.001) and 1.036 (95% CI 0.808-1.327, P  > 0.05), respectively. The risk of CVD among those with comorbid hypertension and diabetes exceeded the sum of the risks due to hypertension and diabetes alone (relative excess risk ratio = 0.567, 95% CI 0.136-0.999).

Conclusion: Individuals with comorbid hypertension and diabetes had greater risks of CVD and all-cause mortality, beyond those associated with either condition alone. The synergistic interaction between hypertension and diabetes aggravated the risk of CVD.

高血压和糖尿病对心血管疾病发病率和全因死亡率的影响:来自中国健康与退休纵向研究队列的研究结果
目的:本研究旨在探讨高血压和糖尿病对中国中老年人群心血管疾病和全因死亡率的个体和联合影响。方法:从中国健康与退休纵向研究(CHARLS)中纳入9681名既往无心血管疾病的个体。参与者被分为四组:单独高血压、单独糖尿病、两种情况都有、两种情况都没有。采用多变量Cox比例风险模型来估计全因死亡率和心血管疾病的风险。结果:在7年的随访中,记录了967例死亡和1535例CVD事件。与无高血压和糖尿病患者比较,高血压单独患者[校正危险比(aHR) 1.571, 95%可信区间(CI) 1.316 ~ 1.875, P 0.05]。合并高血压和糖尿病的患者发生心血管疾病的风险大于单独合并高血压和糖尿病的风险之和(相对超额风险比= 0.567,95% CI 0.136-0.999)。结论:合并高血压和糖尿病的个体发生心血管疾病和全因死亡率的风险高于单独合并高血压和糖尿病的个体。高血压和糖尿病之间的协同作用加重了心血管疾病的风险。
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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来源期刊
Journal of Hypertension
Journal of Hypertension 医学-外周血管病
CiteScore
7.90
自引率
6.10%
发文量
1389
审稿时长
3 months
期刊介绍: The Journal of Hypertension publishes papers reporting original clinical and experimental research which are of a high standard and which contribute to the advancement of knowledge in the field of hypertension. The Journal publishes full papers, reviews or editorials (normally by invitation), and correspondence.
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