CV outcomes highly attributed to hypertension among Framingham participants with diabetes

**Chen G. Hypertension. 2011;doi:10.1161/HYPERTENSIONAHA.110.162446.**

Issue: May 2011

For participants with diabetes from the Framingham Heart Study, the likelihood of all-cause mortality and CVD events were significantly increased in those who also presented with hypertension.

“Our key finding is that the presence of hypertension is the strongest driver of CV outcomes in individuals with diabetes mellitus,” the researchers wrote. “Our study is consistent with other studies that have demonstrated [a roughly] twofold increased risk for CV events and deaths in diabetic individuals with hypertension compared with those with normal BPs.”

Researchers of the retrospective analysis looked at participants from the original and offspring cohorts of the Framingham Heart Study. Each participant (n=1,145) had newly diagnosed diabetes without a previous history of CV events, whereas 58% (n=663) had hypertension at the time of diabetes diagnosis. Primary outcomes were defined as all-cause and CVD-related mortality, and secondary outcomes were nonfatal CVD events, including HF, MI and stroke.

During a mean follow-up of 3.6 years, 125 deaths and 204 CV events were reported. Compared with normotensive individuals with diabetes, those presenting with hypertension at the time of diabetes diagnosis had a higher rate of all-cause mortality (P<.001) and CV events (P<.001).

After adjustment for clinical and demographic covariates, those with hypertension and diabetes had a 72% increased risk for all-cause mortality and 57% increased risk for CVD events. The population-attributable risk from hypertension in those with diabetes mellitus was 30% for all-cause death and 25% for CVD events, which was noticeably higher compared with the population-attributable risk after adjustment for concurrent hypertension (all-cause mortality, 7%; CVD events, 9%).

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