A combination of prediabetes and hypertension increases the risk for cardiovascular disease (CVD) more than either risk factor alone, according to a new research published April 18 in Hypertension.
“In this prospective study on new-onset CAD patients undergoing coronary angiography, we, interestingly, found that pre-diabetes was not associated with an increased CVD risk and had a similar risk with subjects with normal glucose regulation (NGR),” wrote lead author Jian-Jun Li, Chinese Academy of Medical Sciences and Peking Union Medical College in Beijing and colleagues. “However, when it occurred in the hypertensive subjects, the risk for more severe coronary lesions was significantly elevated compared with that for participants with normal plasma glucose and normal blood pressure.”
Chinese researchers sought to determine whether prediabetes mellitus (pre-DM) is an independent risk factor for CVD in individuals with or without hypertension.
More than 7,000 patients with angina-like chest pain who received coronary angiography were evaluated along with 4,193 patients with angiography-proven stable, new-onset coronary artery disease. The researchers divided the individuals according to their diabetes mellitus status and then were further divided by hypertension status.
Among the subjects, 43 percent were defined as pre-DM, approximately 36 percent were defined as DM and approximately 22 percent were defined as NGR.
The researchers followed up at six-month intervals to track all-cause death, nonfatal myocardial infarction, stroke, unplanned revascularization and hospitalized unstable angina. They compared the instances, severity and outcomes of coronary artery disease among the groups.
During an average of more than 11,300 patient-years of follow-up, the researchers found 434, or 10.4 percent, cardiovascular events occurred.
There was no significant difference observed in coronary severity and end points between the pre-DM and NGR groups. When hypertension was incorporated into the analysis, the researchers found an increase in cardiovascular disease risk, assessed by coronary severity and clinical prognosis in the pre-DM plus hypertension and the DM plus hypertension groups, compared to the control group.
“Although this is a relatively short-term study, longer-term follow-up of this population will lead to better understanding of the effects of pre-DM alone or plus hypertension on CVD outcomes,” the authors concluded. “Moreover, a prospective randomized control trial with a large sample size and long-term follow-up is urgently needed to further confirm our findings.”
As a senior news writer for TriMed, Subrata covers cardiology, clinical innovation and healthcare business. She has a master’s degree in communication management and 12 years of experience in journalism and public relations.