title: Diabetes and 15-year cardiovascular mortality in a Chinese population: Differential impact of hypertension and metabolic syndrome.
abstract: BACKGROUND
  It remains unclear if the risk for cardiovascular (CV) mortality in patients with diabetes mellitus (DM) is equivalent to that in patients with a history of cardiac disease in Asian populations. The aims of the present study were to investigate whether or not non-heart disease (HD) DM subjects have a similar risk of CV mortality as HD patients without DM (non-DM HD), and whether or not hypertension (HT) or metabolic syndrome (MS) is a CV mortality marker for diabetic subjects identified from a community-based population.
  
  
  METHODS
  We followed 11,058 Chinese people aged > or = 30 years on Kinmen island for a median of 15.0 years.
  
  
  RESULTS
  The age-, sex- and smoking-adjusted hazard ratios for CV mortality were 3.56 [95% confidence interval (CI): 1.99-6.36] for DM subjects with HD, 1.64 (95% CI: 1.25-2.16) for DM without HD (non-HD DM) subjects, and 1.63 (95% CI: 1.09-2.44) for non-DM HD patients, when compared with subjects without DM and HD. Among the 827 non-HD DM subjects identified at the baseline survey, the age-, sex- and smoking-adjusted hazard ratios for CV mortality were 2.36 (95% CI: 1.30-4.28) for the presence versus absence of HT, and 1.23 (95% CI: 0.65-2.34) for the presence versus absence of MS.
  
  
  CONCLUSIONS
  Non-HD DM subjects had a similar risk of CV mortality to non-DM HD subjects in this Chinese population. The presence of HT but not MS substantially increased CV mortality risk in the DM subjects.
authors.affiliation: Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, R.O.C.
authors.forename: Shao-Yuan
authors.initials: SY
authors.lastname: Chuang
authors.forename: Pai-Feng
authors.initials: PF
authors.lastname: Hsu
authors.forename: Shih-Hsien
authors.initials: SH
authors.lastname: Sung
authors.forename: Pesus
authors.initials: P
authors.lastname: Chou
authors.forename: Chen-Huan
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000401:mortality*; D002681:China; D048909:Diabetes Complications / Q000401:mortality*; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000401:mortality*; D008297:Male; D024821:Metabolic Syndrome / Q000401:mortality*; D008875:Middle Aged