title: New-onset diabetes and cardiovascular events in essential hypertensives: a 6-year follow-up study.
abstract: BACKGROUND
  Controversy still exists regarding the impact of new-onset diabetes (NOD) on CV outcomes among patients with hypertension. Our aim was to determine the incidence of NOD in essential hypertensives and to evaluate its association with major cardiovascular (CV) events.
  
  
  METHODS
  We followed-up for a mean period of 6 years 1572 essential hypertensives (mean age 54.3 years, 696 males) for the incidence of NOD, as well as of fatal and non-fatal coronary artery disease and stroke. Based on the development of NOD, the cohort was divided into patients with pre-existing diabetes (10%), patients with NOD (10%) and those who remained free from diabetes.
  
  
  RESULTS
  During the follow-up period, new or recurrent cases of coronary artery disease and stroke events occurred at a rate of 5.6% (n = 88) and 4.65% (n = 73). The independent predictors for NOD were age (OR = 1.026, p = 0.041), waist circumference (OR = 1.044, p < 0.001), family history of diabetes (OR = 2.173, p = 0.003) and systolic BP at follow-up (OR 1.022, p = 0.044). The presence of NOD was independently associated with greater incidence of stroke (HR 2.404, p = 0.046), along with age (HR 1.078, p < 0.001), duration of hypertension (HR 1.039, p = 0.017) and office systolic blood pressure at follow-up (HR 1.022, p = 0.026), whereas development of NOD had no relationship with the incidence of coronary artery disease.
  
  
  CONCLUSIONS
  Our findings indicate the high incidence of NOD and its close association with stroke in essential hypertension. Poorer control of hypertension appears to be a common denominator of both NOD and stroke in this setting.
authors.affiliation: First Cardiology Clinic, Hippokration Hospital, University of Athens Medical School, Athens, Greece.
authors.forename: Dimitris
authors.initials: D
authors.lastname: Tsiachris
authors.forename: Costas
authors.initials: C
authors.lastname: Tsioufis
authors.forename: Costas
authors.initials: C
authors.lastname: Thomopoulos
authors.forename: Dimitris
authors.initials: D
authors.lastname: Syrseloudis
authors.forename: Velissarios
authors.initials: V
authors.lastname: Antonakis
authors.forename: Louiza
authors.initials: L
authors.lastname: Lioni
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kallikazaros
authors.forename: Thomas
authors.initials: T
authors.lastname: Makris
authors.forename: Vasilis
authors.initials: V
authors.lastname: Papademetriou
authors.forename: Christodoulos I
authors.initials: CI
authors.lastname: Stefanadis
mesh_terms: D017668:Age of Onset; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012307:Risk Factors