title: The impact of diabetes and coronary artery disease on mortality and morbidity in patients with hypertension.
abstract: OBJECTIVE
  We evaluated the impact of diabetes mellitus (DM) and/or coronary artery disease (CAD) on cardiovascular endpoints in a cohort of hypertensive patients.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Internal Medicine, Göztepe Training and Research Hospital, Istanbul, Turkey. aytekinoguz@hotmail.com
authors.forename: Aytekin
authors.initials: A
authors.lastname: Oğuz
authors.forename: Taner
authors.initials: T
authors.lastname: Damci
authors.forename: Seçkin
authors.initials: S
authors.lastname: Pehlivanoğlu
authors.forename: Hakan
authors.initials: H
authors.lastname: Kültürsay
authors.forename: Lale
authors.initials: L
authors.lastname: Tokgözoğlu
authors.forename: Mustafa
authors.initials: M
authors.lastname: Senocak
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yusuf
mesh_terms: D000368:Aged; D002423:Cause of Death; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000453:epidemiology* / Q000401:mortality; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000401:mortality; D003925:Diabetic Angiopathies / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000401:mortality; D008297:Male; D015337:Multicenter Studies as Topic; D012907:Smoking / Q000453:epidemiology; D016019:Survival Analysis; D014421:Turkey / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL; D002784:Cholesterol