title: The association and interaction analysis of hypertension and diabetes mellitus on diastolic heart failure in a high-risk population.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the extent to which hypertension (HT) interacts with diabetes mellitus (DM) to affect diastolic heart failure (DHF) in a high-risk population.
  
  
  METHODS
  We conducted a hospital-based case-control study to investigate the relationship between HT or DM and DHF in 251 patients (case: 133 patients with DHF; control: 118 patients without DHF). Echocardiography was used to assess left ventricular (LV) diastolic function. The association between HT or DM and DHF was assessed by multivariate logistic regression (MLR) analysis controlling for confounders. The effect of the interaction between HT and DM on DHF was assessed in MLR models. Interaction on an additive scale can be calculated by using the relative excess risk due to interaction (RERI), the proportion attributable to interaction (AP), and the synergy index (S).
  
  
  RESULTS
  The MLR analyses showed that HT and DM were independent predictors of DHF after adjustment for potential confounders (OR = 2.35-3.14, P<0.05 for all models). DHF was affected by the interaction between HT and DM (ORInt = 3.11-4.31, P Int<0.1, RETI = 2.13-2.69, AP = 0.38-0.49 and S = 4.11-6.80).
  
  
  CONCLUSIONS
  The findings provide evidence that HT and DM are independent predictors of DHF and that both risk factors act synergistically to influence DHF in a Chinese high-risk population.
authors.affiliation: Department of Endocrinology and Metabolism, Dahua Hospital Shanghai, China.
authors.forename: Xiang-Ying
authors.initials: XY
authors.lastname: Meng
authors.affiliation: Department of Endocrinology and Metabolism, Dahua Hospital Shanghai, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Cardiology, Fudan University Hua Shan Hospital Shanghai, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, Tongji University School of Medicine Shanghai, China.
authors.forename: Zi-Hui
authors.initials: ZH
authors.lastname: Tang
keywords: Hypertension; diabetes mellitus; diastolic heart failure; synergy effect