Effect of tight control of HbA1c and blood pressure on cardiovascular diseases in type 2 diabetes: An observational study from the Swedish National Diabetes Register (NDR)
(2009) In Diabetes Research and Clinical Practice 86(1). p.74-81- Abstract
- Aim: To estimate hazard ratio (HR) of first incident fatal/non-fatal cardiovascular diseases (CVD) in female/male type 2 diabetic patients, with tight versus adverse control of HbA1c and blood pressure (BP) at baseline, age 30-70 years, no baseline CVD, followed for mean 5.7 years. Methods: 2593 patients with tight control of HbA1c <7.5% and BP <= 140/90 mmHg (median 6.5%/130/80 mmHg), and 2160 patients with adverse control 7.5-9.0%/141-190/91-110 mmHg (median 8.1%/155/85 mmHg). Results: The hazard ratio (HR) for CVD with tight/adverse control was 0.67 (0.55-0.80; p < 0.001), adjusting for age, sex, duration, hypoglycaemic treatment, smoking, BMI, lipid-lowering drugs, antihypertensive drugs, microalbuminuria. Adjusted HR for... (More)
- Aim: To estimate hazard ratio (HR) of first incident fatal/non-fatal cardiovascular diseases (CVD) in female/male type 2 diabetic patients, with tight versus adverse control of HbA1c and blood pressure (BP) at baseline, age 30-70 years, no baseline CVD, followed for mean 5.7 years. Methods: 2593 patients with tight control of HbA1c <7.5% and BP <= 140/90 mmHg (median 6.5%/130/80 mmHg), and 2160 patients with adverse control 7.5-9.0%/141-190/91-110 mmHg (median 8.1%/155/85 mmHg). Results: The hazard ratio (HR) for CVD with tight/adverse control was 0.67 (0.55-0.80; p < 0.001), adjusting for age, sex, duration, hypoglycaemic treatment, smoking, BMI, lipid-lowering drugs, antihypertensive drugs, microalbuminuria. Adjusted HR for myocardial infarction, coronary heart disease, stroke and total mortality were 0.72 (0.56-0.92; p = 0.01), 0.69 (0.55-0.86; p < 0.001), 0.62 (0.45-0.84; p < 0.001), 1.00 (0.72-1.39). The partial population-attributable risk percent for myocardial infarction, stroke and CVD was 23%, 33%, 29% if adverse HbA1c/BP control could be avoided, while 43%, 38%, 39% with overweight and smoking also avoided. Baseline lower BMI and absence of microalbuminuria were associated with tight control. Conclusion: Median difference of HbA1c/BP 1.6%/25/5 mmHg between tight and adverse control considerably reduced the risk of cardiovascular diseases. The findings call for a multi-factorial approach to improve HbA1c, BP, obesity, smoking, and microalbuminuria. (C) 2009 Elsevier Ireland Ltd. All rights reserved. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1506982
- author
- Cederholm, Jan ; Zethelius, Bjorn ; Nilsson, Peter LU ; Eeg-Olofsson, Katarina ; Eliasson, Bjorn and Gudbjornsdottir, Soffia
- organization
- publishing date
- 2009
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- infarction, Myocardial, Cardiovascular diseases, Diabetes, Blood pressure, Stroke
- in
- Diabetes Research and Clinical Practice
- volume
- 86
- issue
- 1
- pages
- 74 - 81
- publisher
- Elsevier
- external identifiers
-
- wos:000270769700012
- scopus:69849089051
- ISSN
- 1872-8227
- DOI
- 10.1016/j.diabres.2009.07.003
- language
- English
- LU publication?
- yes
- id
- 7c343b68-4bce-4813-b86f-b826f246e6b1 (old id 1506982)
- date added to LUP
- 2016-04-01 12:24:09
- date last changed
- 2022-02-03 21:39:51
@article{7c343b68-4bce-4813-b86f-b826f246e6b1, abstract = {{Aim: To estimate hazard ratio (HR) of first incident fatal/non-fatal cardiovascular diseases (CVD) in female/male type 2 diabetic patients, with tight versus adverse control of HbA1c and blood pressure (BP) at baseline, age 30-70 years, no baseline CVD, followed for mean 5.7 years. Methods: 2593 patients with tight control of HbA1c <7.5% and BP <= 140/90 mmHg (median 6.5%/130/80 mmHg), and 2160 patients with adverse control 7.5-9.0%/141-190/91-110 mmHg (median 8.1%/155/85 mmHg). Results: The hazard ratio (HR) for CVD with tight/adverse control was 0.67 (0.55-0.80; p < 0.001), adjusting for age, sex, duration, hypoglycaemic treatment, smoking, BMI, lipid-lowering drugs, antihypertensive drugs, microalbuminuria. Adjusted HR for myocardial infarction, coronary heart disease, stroke and total mortality were 0.72 (0.56-0.92; p = 0.01), 0.69 (0.55-0.86; p < 0.001), 0.62 (0.45-0.84; p < 0.001), 1.00 (0.72-1.39). The partial population-attributable risk percent for myocardial infarction, stroke and CVD was 23%, 33%, 29% if adverse HbA1c/BP control could be avoided, while 43%, 38%, 39% with overweight and smoking also avoided. Baseline lower BMI and absence of microalbuminuria were associated with tight control. Conclusion: Median difference of HbA1c/BP 1.6%/25/5 mmHg between tight and adverse control considerably reduced the risk of cardiovascular diseases. The findings call for a multi-factorial approach to improve HbA1c, BP, obesity, smoking, and microalbuminuria. (C) 2009 Elsevier Ireland Ltd. All rights reserved.}}, author = {{Cederholm, Jan and Zethelius, Bjorn and Nilsson, Peter and Eeg-Olofsson, Katarina and Eliasson, Bjorn and Gudbjornsdottir, Soffia}}, issn = {{1872-8227}}, keywords = {{infarction; Myocardial; Cardiovascular diseases; Diabetes; Blood pressure; Stroke}}, language = {{eng}}, number = {{1}}, pages = {{74--81}}, publisher = {{Elsevier}}, series = {{Diabetes Research and Clinical Practice}}, title = {{Effect of tight control of HbA1c and blood pressure on cardiovascular diseases in type 2 diabetes: An observational study from the Swedish National Diabetes Register (NDR)}}, url = {{http://dx.doi.org/10.1016/j.diabres.2009.07.003}}, doi = {{10.1016/j.diabres.2009.07.003}}, volume = {{86}}, year = {{2009}}, }