OBJECTIVES: We evaluated the impact of diabetes mellitus (DM) and/or coronary artery disease (CAD) on cardiovascular endpoints in a cohort of hypertensive patients. STUDY DESIGN: The Vascular Risk Study is a cross-sectional, multicenter, observational study conducted among 5,600 patients from various regions of Turkey. This analysis included 2,664 patients (1,643 women, 1,021 men; mean age 65.3 years; range 55-99 years) whose follow-up data were adequate among a population of 4,506 hypertensive subjects. Cardiovascular primary and secondary endpoints at the end of a five-year follow-up were assessed in patients who had hypertension alone, and in those having DM and/or CAD. Information on the cause of death was obtained from the relatives of the patients by follow-up phone calls. RESULTS: There were 1,171 patients (44%) with isolated hypertension, 631 (23.7%) with DM, 530 (19.9%) with CAD, and 332 (12.5%) with both DM and CAD. The presence of either DM or CAD was associated with significant increases in the incidences of all endpoints. The occurrences of primary and secondary endpoints, cardiovascular death, and all death were similar in hypertensive patients who had DM without CAD and in patients who had CAD without DM. In survival analysis, the incidence of cardiovascular death was lowest (5.7%) in hypertensive patients without DM and CAD, and highest (18.4%) in hypertensive patients with DM and CAD. The cumulative survival rates were similar in hypertensive patients with either DM or CAD alone (p>0.05). CONCLUSION: This study demonstrated that the level of cardiovascular risk associated with DM was equal to the risk associated with CAD in hypertensive patients and that the coexistence of DM and CAD in these patients increases the risk geometrically.
OBJECTIVES: We evaluated the impact of diabetes mellitus (DM) and/or coronary artery disease (CAD) on cardiovascular endpoints in a cohort of hypertensivepatients. STUDY DESIGN: The Vascular Risk Study is a cross-sectional, multicenter, observational study conducted among 5,600 patients from various regions of Turkey. This analysis included 2,664 patients (1,643 women, 1,021 men; mean age 65.3 years; range 55-99 years) whose follow-up data were adequate among a population of 4,506 hypertensive subjects. Cardiovascular primary and secondary endpoints at the end of a five-year follow-up were assessed in patients who had hypertension alone, and in those having DM and/or CAD. Information on the cause of death was obtained from the relatives of the patients by follow-up phone calls. RESULTS: There were 1,171 patients (44%) with isolated hypertension, 631 (23.7%) with DM, 530 (19.9%) with CAD, and 332 (12.5%) with both DM and CAD. The presence of either DM or CAD was associated with significant increases in the incidences of all endpoints. The occurrences of primary and secondary endpoints, cardiovascular death, and all death were similar in hypertensivepatients who had DM without CAD and in patients who had CAD without DM. In survival analysis, the incidence of cardiovascular death was lowest (5.7%) in hypertensivepatients without DM and CAD, and highest (18.4%) in hypertensivepatients with DM and CAD. The cumulative survival rates were similar in hypertensivepatients with either DM or CAD alone (p>0.05). CONCLUSION: This study demonstrated that the level of cardiovascular risk associated with DM was equal to the risk associated with CAD in hypertensivepatients and that the coexistence of DM and CAD in these patients increases the risk geometrically.
Authors: Anu Kuriakose; Thekkumkara Surendran Nair Anish; Biju Soman; Ron Thomas Varghese; Thekkumkara Prabhakaran Sreelal; Alice Matilda Mendez; Anitha Abraham Journal: Int J Prev Med Date: 2014-05