title: Benefits of early hypertension control on cardiovascular outcomes in patients with diabetes.
abstract: OBJECTIVE
  To assess the impact of early hypertension (HT) control on occurrence of subsequent major cardiovascular events in those with diabetes and recent-onset HT.
  
  
  METHODS
  Study subjects were 15,665 adults with diabetes but no diagnosed coronary or cerebrovascular disease at baseline who met standard criteria for new-onset HT. Poisson regression models assessed whether adequate blood pressure control within 1 year of HT onset predicts subsequent occurrence of major cardiovascular events with and without adjustment for baseline Framingham Risk Score (FRS) and other covariates.
  
  
  RESULTS
  Mean age was 51.5 years, and mean blood pressure at HT onset was 136.8/80.8 mmHg. In the year after HT onset, mean blood pressure decreased to 131.4/78.0 mmHg and was <130/80 mmHg in 32.9% of subjects and <140/90 mmHg in 80.2%. Over a mean follow-up of 3.2 years, age-adjusted rates of major cardiovascular events in those with mean 1-year blood pressure measurements of <130/80, 130-139/80-89, and ≥140/90 mmHg were 5.10, 4.27, and 6.94 events/1,000 person-years, respectively (P = 0.004). In FRS-adjusted models, rates of major cardiovascular events were significantly higher in those with mean blood pressure ≥140/90 mmHg in the first year after HT onset (rate ratio 1.30 [95% CI 1.01-1.169]; P = 0.04).
  
  
  CONCLUSIONS
  Failure to adequately control BP within 1 year of HT onset significantly increased the likelihood of major cardiovascular events within 3 years. Prompt control of new-onset HT in patients with diabetes may provide important short-term clinical benefits.
authors.affiliation: HealthPartners Research Foundation, Minneapolis, MN, USA. patrick.j.oconnor@healthpartners.com
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: O'Connor
authors.forename: Gabriela
authors.initials: G
authors.lastname: Vazquez-Benitez
authors.forename: Julie A
authors.initials: JA
authors.lastname: Schmittdiel
authors.forename: Emily D
authors.initials: ED
authors.lastname: Parker
authors.forename: Nicole K
authors.initials: NK
authors.lastname: Trower
authors.forename: Jay R
authors.initials: JR
authors.lastname: Desai
authors.forename: Karen L
authors.initials: KL
authors.lastname: Margolis
authors.forename: David J
authors.initials: DJ
authors.lastname: Magid
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies