TY - JOUR
T1 - 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
AU - Tu, Qiang
AU - Hyun, Karice
AU - Lin, Shuanglan
AU - Hafiz, Nashid
AU - Manandi, Deborah
AU - Li, Emily
AU - Wang, Xinzheng
AU - Wu, Haisheng
AU - Redfern, Julie
N1 - Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2024/12/12
Y1 - 2024/12/12
N2 - 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.
AB - 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.
U2 - 10.1097/HJH.0000000000003946
DO - 10.1097/HJH.0000000000003946
M3 - Article
C2 - 39791435
SN - 0263-6352
JO - Journal of Hypertension
JF - Journal of Hypertension
ER -