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Excess cardiovascular risk in diabetes ‘due to hypertension’

By Lilian Anekwe

Diabetes patients may be at increased risk of cardiovascular events largely because of co-existing hypertension, researchers have said.

The results back the move by Joint British Societies’ guideline advisors – as revealed by Pulse last year – to review whether diabetes should be downgraded from its current status as a cardiovascular disease equivalent.

Researchers retrospectively analysed data from the original and offspring cohorts of Boston University’s long established Framingham heart study.

Among 1145 patients with newly diagnosed diabetes and no history of cardiovascular events, 58% had hypertension at the time that diabetes mellitus was diagnosed. During 4,154 person-years of follow-up, 125 died and 204 experienced a cardiovascular event.

After adjustment for demographic and clinical covariates, hypertension was associated with a 72% increase in the risk of all-cause death and a 57% increase in the risk of any cardiovascular event in individuals with diabetes mellitus.

Dr Finlay McAlister, an associate professor at the University of Alberta’s department of medicine in Canada, concluded: ‘Although diabetes mellitus is associated with increased risks for death and cardiovascular events in the Framingham cohort, we have established that much of this excess risk is attributable to co-existent hypertension in diabetic individuals.

‘Increased attention to the role of blood pressure control in preventing cardiovascular events in individuals with diabetes mellitus is essential.’

Hypertension 2011 online March 23

Excess cardiovascular risk in diabetes ‘due to hypertension’