Blood pressure and cardiovascular diseases in Chinese adults with type 2 diabetes: a prospective cohort study
<p><strong>Background:</strong> Controversy persists about the relationship of blood pressure with cardiovascular diseases (CVD) in diabetes and associated disease burden. We assessed these associations among Chinese adults with type 2 diabetes (T2D).</p> <p><strong...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
Elsevier
2021
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| _version_ | 1797074653449027584 |
|---|---|
| author | Bragg, FJ Halsey, J Guo, Y Zhang, H Yang, L Sun, X Pei, P Chen, Y Du, H Yu, C Clarke, R Lv, J Chen, J Li, L Chen, Z |
| author_facet | Bragg, FJ Halsey, J Guo, Y Zhang, H Yang, L Sun, X Pei, P Chen, Y Du, H Yu, C Clarke, R Lv, J Chen, J Li, L Chen, Z |
| author_sort | Bragg, FJ |
| collection | OXFORD |
| description | <p><strong>Background:</strong> Controversy persists about the relationship of blood pressure with cardiovascular diseases
(CVD) in diabetes and associated disease burden. We assessed these associations among Chinese adults
with type 2 diabetes (T2D).</p>
<p><strong>Methods:</strong> In 2004–08, the China Kadoorie Biobank recruited >512,000 adults aged 30–79 years from
10 localities across China, including 26,315 with T2D (based on self-report or plasma glucose measurement) but no prior CVD, followed-up for ~9 years. Cox regression yielded adjusted HR for major CVD and
all-cause mortality associated with 10 mmHg higher usual (longer-term average) SBP. Attributable fractions were estimated to assess cardiovascular mortality burden due to uncontrolled hypertension (SBP
≥130 mmHg or DBP ≥80 mmHg).</p>
<p><strong>Findings:</strong> Overall, 75.7% of participants had self-reported (24.8%) or screen-detected (50.9%) (SBP
≥130 mmHg or DBP ≥80 mmHg) hypertension. Among individuals with self-reported hypertension, 82.3%
were treated, of whom 9.3% achieved control. There were positive log-linear associations of blood pressure with CVD, with no evidence of a threshold down to ~120 mmHg for usual SBP. Each 10 mmHg higher
usual SBP was associated with HR of 1.28 (95% CI 1.25–1.30), 1.18 (1.15–1.21), 1.17 (1.15–1.19) and 1.45
(1.38–1.52) for cardiovascular death (n=1807), major coronary event (n=1190), ischaemic stroke (n=4362)
and intracerebral haemorrhage (n=469), respectively. There was an apparent J-shaped association with
all-cause mortality (n=4503). In this diabetes population, uncontrolled hypertension accounted for 39%
of cardiovascular deaths.</p>
<p><strong>Interpretation:</strong> Uncontrolled hypertension is common in Chinese adults with T2D, resulting in substantial
excess risks of CVD. Improved hypertension management could avoid a large number of cardiovascularrelated deaths.</p> |
| first_indexed | 2024-03-06T23:39:21Z |
| format | Journal article |
| id | oxford-uuid:6ec1a05f-ddc6-49e9-b8da-602c437a5c92 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T23:39:21Z |
| publishDate | 2021 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:6ec1a05f-ddc6-49e9-b8da-602c437a5c922022-03-26T19:26:33ZBlood pressure and cardiovascular diseases in Chinese adults with type 2 diabetes: a prospective cohort studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6ec1a05f-ddc6-49e9-b8da-602c437a5c92EnglishSymplectic ElementsElsevier2021Bragg, FJHalsey, JGuo, YZhang, HYang, LSun, XPei, PChen, YDu, HYu, CClarke, RLv, JChen, JLi, LChen, Z<p><strong>Background:</strong> Controversy persists about the relationship of blood pressure with cardiovascular diseases (CVD) in diabetes and associated disease burden. We assessed these associations among Chinese adults with type 2 diabetes (T2D).</p> <p><strong>Methods:</strong> In 2004–08, the China Kadoorie Biobank recruited >512,000 adults aged 30–79 years from 10 localities across China, including 26,315 with T2D (based on self-report or plasma glucose measurement) but no prior CVD, followed-up for ~9 years. Cox regression yielded adjusted HR for major CVD and all-cause mortality associated with 10 mmHg higher usual (longer-term average) SBP. Attributable fractions were estimated to assess cardiovascular mortality burden due to uncontrolled hypertension (SBP ≥130 mmHg or DBP ≥80 mmHg).</p> <p><strong>Findings:</strong> Overall, 75.7% of participants had self-reported (24.8%) or screen-detected (50.9%) (SBP ≥130 mmHg or DBP ≥80 mmHg) hypertension. Among individuals with self-reported hypertension, 82.3% were treated, of whom 9.3% achieved control. There were positive log-linear associations of blood pressure with CVD, with no evidence of a threshold down to ~120 mmHg for usual SBP. Each 10 mmHg higher usual SBP was associated with HR of 1.28 (95% CI 1.25–1.30), 1.18 (1.15–1.21), 1.17 (1.15–1.19) and 1.45 (1.38–1.52) for cardiovascular death (n=1807), major coronary event (n=1190), ischaemic stroke (n=4362) and intracerebral haemorrhage (n=469), respectively. There was an apparent J-shaped association with all-cause mortality (n=4503). In this diabetes population, uncontrolled hypertension accounted for 39% of cardiovascular deaths.</p> <p><strong>Interpretation:</strong> Uncontrolled hypertension is common in Chinese adults with T2D, resulting in substantial excess risks of CVD. Improved hypertension management could avoid a large number of cardiovascularrelated deaths.</p> |
| spellingShingle | Bragg, FJ Halsey, J Guo, Y Zhang, H Yang, L Sun, X Pei, P Chen, Y Du, H Yu, C Clarke, R Lv, J Chen, J Li, L Chen, Z Blood pressure and cardiovascular diseases in Chinese adults with type 2 diabetes: a prospective cohort study |
| title | Blood pressure and cardiovascular diseases in Chinese adults with type 2 diabetes: a prospective cohort study |
| title_full | Blood pressure and cardiovascular diseases in Chinese adults with type 2 diabetes: a prospective cohort study |
| title_fullStr | Blood pressure and cardiovascular diseases in Chinese adults with type 2 diabetes: a prospective cohort study |
| title_full_unstemmed | Blood pressure and cardiovascular diseases in Chinese adults with type 2 diabetes: a prospective cohort study |
| title_short | Blood pressure and cardiovascular diseases in Chinese adults with type 2 diabetes: a prospective cohort study |
| title_sort | blood pressure and cardiovascular diseases in chinese adults with type 2 diabetes a prospective cohort study |
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