on March 22, 2004
Hypertension. 2004
Published online before print March 22, 2004, doi: 10.1161/01.HYP.0000125726.92964.ab
Published online before print March 22, 2004, doi: 10.1161/01.HYP.0000125726.92964.ab
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Submitted on September 30, 2003
From Dipartimento Malattie Cardiovascolari, Università di Perugia-Ospedale Silvestrini (P.V., F.A., C.B., L.F., S.N., C.B.C.P.), Italy; Dipartimento di Medicina Interna (G.R.), Università di Perugia, Italy; and Ospedale Beato, G. Villa, Città della Pieve (R.G.). * To whom correspondence should be addressed. E-mail: verdec{at}tin.it.
Abstract--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 4.70x100 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.
Revised on October 24, 2003
Adverse Prognostic Significance of New Diabetes in Treated Hypertensive Subjects
Paolo Verdecchia*;
Key words: hypertension • echocardiography • hypertrophy • blood pressure • epidemiology • diuretics
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|
|
|
|
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