New-onset diabetes and cardiovascular events in essential hypertensives: a 6-year follow-up study.
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.
Tsiachris
Dimitris
D
First Cardiology Clinic, Hippokration Hospital, University of Athens Medical School, Athens, Greece.
Tsioufis
Costas
C
Thomopoulos
Costas
C
Syrseloudis
Dimitris
D
Antonakis
Velissarios
V
Lioni
Louiza
L
Kallikazaros
Ioannis
I
Makris
Thomas
T
Papademetriou
Vasilis
V
Stefanadis
Christodoulos I
CI
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