Different combinations of glucose tolerance and blood pressure status and incident cardiovascular disease and all-cause mortality events

• Published in: Journal of human hypertension 2017-11, Vol.31 (11), p.744-749
• Main Authors: Hajebrahimi, M A, Akbarpour, S, Eslami, A, Azizi, F, Hadaegh, F
• Format: Article
• Language: English
• Subjects: 692/699/2743/137/773; 692/699/75/243; Adult; Analysis; Antihypertensives; Biomarkers - blood; Blood Glucose - metabolism; Blood Pressure; Cardiovascular disease; Cardiovascular diseases; Care and treatment; Cause of Death; Complications and side effects; Demographic aspects; Diabetes; Diabetes mellitus; Diabetes Mellitus - blood; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - mortality; Epidemiology; Female; Glucose; Glucose intolerance; Glucose tolerance; Health Administration; Health aspects; Health risk assessment; Humans; Hypertension - diagnosis; Hypertension - epidemiology; Hypertension - mortality; Hypertension - physiopathology; Incidence; Iran; Iran - epidemiology; Male; Medicine; Medicine & Public Health; Middle Aged; Mortality; original-article; Patient outcomes; Phenotypes; Prediabetic state; Prediabetic State - blood; Prediabetic State - epidemiology; Prehypertension - epidemiology; Prehypertension - physiopathology; Prognosis; Prospective Studies; Public Health; Risk Factors; Time Factors
• ISSN: 0950-9240; 1476-5527
• DOI: 10.1038/jhh.2017.49

The purpose of this study was to evaluate the effect of combinations of blood pressure and glucose tolerance status on cardiovascular and all-cause mortality. A total of 7619 participants aged ⩾30 years old were stratified to nine categories as follows: (1) normotension (NTN) and normal glucose tolerance (NGT) (reference group), (2) NTN and pre-diabetes mellitus (pre-DM), (3) NTN and DM, (4) pre-hypertension (pre-HTN) and NGT, (5) pre-HTN and pre-DM, (6) pre-HTN and DM, (7) HTN and NGT, (8) HTN and pre-DM and (9) HTN and DM. Cox proportional hazards were applied to calculate the multivariate hazard ratios (HRs) of different groups for outcomes. For all-cause mortality outcomes, prevalent cardiovascular disease (CVD) was also adjusted. In a median follow-up of 11.3 years, 696 CVD and 412 all-cause mortality events occurred. Among the population free from CVD at baseline ( n =7249), presence of HTN was associated with increased risk of CVD, regardless of glucose tolerance status with HRs of 1.97 (95% confidence interval (CI), 1.49–2.61), 2.25 (1.68–3.02) and 3.16 (2.28–4.37) for phenotypes of HTN and NGT, HTN and pre-DM and HTN and DM for CVD, respectively; corresponding HRs for all-cause mortality were 1.65 (95% CI, 1.15–2.37), 1.69 (1.15–2.49) and 2.73 (1.80–4.14), respectively. Phenotypes of NTN and pre-DM (1.48; 1.03–2.14) and NTN and DM (2.04; 1.06–3.92) were also associated with CVD and all-cause mortality, respectively. HTN was significantly associated with CVD/mortality events, regardless of glucose tolerance status. Blood pressure