Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations

Thomas Sehestedt; Tine W. Hansen; Yan Li; Tom Richart; Jose Boggia; Masahiro Kikuya; Lutgarde Thijs; Katarzyna Stolarz-Skrzypek; Edoardo Casiglia; Valerie Tikhonoff; Sofia Malyutina; Yuri Nikitin; Kristina Bjorklund-Bodegard; Tatiana Kuznetsova; Takayoshi Ohkubo; Lars Lind; Christian Torp-Pedersen; Jorgen Jeppesen; Hans Ibsen; Yutaka Imai; Jiguang Wang; Edgardo Sandoya; Kalina Kawecka-Jaszcz; Jan A. Staessen

doi:10.1038/hr.2011.6

Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations

Thomas Sehestedt, Tine W. Hansen, Yan Li, Tom Richart, Jose Boggia, Masahiro Kikuya, Lutgarde Thijs, Katarzyna Stolarz-Skrzypek, Edoardo Casiglia, Valerie Tikhonoff, Sofia Malyutina, Yuri Nikitin, Kristina Bjorklund-Bodegard, Tatiana Kuznetsova, Takayoshi Ohkubo, Lars Lind, Christian Torp-Pedersen, Jorgen Jeppesen, Hans Ibsen, Yutaka ImaiJiguang Wang, Edgardo Sandoya, Kalina Kawecka-Jaszcz, Jan A. Staessen^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

It remains unknown whether diabetes and high blood pressure (BP) are simply additive risk factors for cardiovascular outcome or whether they act synergistically and potentiate one another. We performed 24-h ambulatory BP monitoring in 8494 subjects (mean age, 54.6 years; 47.0% women; 6.9% diabetic patients) enrolled in prospective population studies in 10 countries. In multivariable-adjusted Cox regression, we assessed the additive as opposed to the synergistic effects of BP and diabetes in relation to a composite cardiovascular endpoint by testing the significance of appropriate interaction terms. During 10.6 years (median follow-up), 1066 participants had a cardiovascular complication. Diabetes mellitus as well as the 24-h ambulatory BP were independent and powerful predictors of the composite cardiovascular endpoint. However, there was no synergistic interaction between diabetes and 24-h, daytime, or nighttime, systolic or diastolic ambulatory BP (P for interaction, 0.07

Original language	English
Pages (from-to)	714-721
Journal	Hypertension Research
Volume	34
Issue number	6
DOIs	https://doi.org/10.1038/hr.2011.6
Publication status	Published - Jun 2011

Keywords

ambulatory blood pressure
cardiovascular risk factors
diabetes mellitus
epidemiology
population science

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10.1038/hr.2011.6

Cite this

Sehestedt, T., Hansen, T. W., Li, Y., Richart, T., Boggia, J., Kikuya, M., Thijs, L., Stolarz-Skrzypek, K., Casiglia, E., Tikhonoff, V., Malyutina, S., Nikitin, Y., Bjorklund-Bodegard, K., Kuznetsova, T., Ohkubo, T., Lind, L., Torp-Pedersen, C., Jeppesen, J., Ibsen, H., ... Staessen, J. A. (2011). Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations. Hypertension Research, 34(6), 714-721. https://doi.org/10.1038/hr.2011.6

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abstract = "It remains unknown whether diabetes and high blood pressure (BP) are simply additive risk factors for cardiovascular outcome or whether they act synergistically and potentiate one another. We performed 24-h ambulatory BP monitoring in 8494 subjects (mean age, 54.6 years; 47.0% women; 6.9% diabetic patients) enrolled in prospective population studies in 10 countries. In multivariable-adjusted Cox regression, we assessed the additive as opposed to the synergistic effects of BP and diabetes in relation to a composite cardiovascular endpoint by testing the significance of appropriate interaction terms. During 10.6 years (median follow-up), 1066 participants had a cardiovascular complication. Diabetes mellitus as well as the 24-h ambulatory BP were independent and powerful predictors of the composite cardiovascular endpoint. However, there was no synergistic interaction between diabetes and 24-h, daytime, or nighttime, systolic or diastolic ambulatory BP (P for interaction, 0.07 ",

keywords = "ambulatory blood pressure, cardiovascular risk factors, diabetes mellitus, epidemiology, population science",

author = "Thomas Sehestedt and Hansen, {Tine W.} and Yan Li and Tom Richart and Jose Boggia and Masahiro Kikuya and Lutgarde Thijs and Katarzyna Stolarz-Skrzypek and Edoardo Casiglia and Valerie Tikhonoff and Sofia Malyutina and Yuri Nikitin and Kristina Bjorklund-Bodegard and Tatiana Kuznetsova and Takayoshi Ohkubo and Lars Lind and Christian Torp-Pedersen and Jorgen Jeppesen and Hans Ibsen and Yutaka Imai and Jiguang Wang and Edgardo Sandoya and Kalina Kawecka-Jaszcz and Staessen, {Jan A.}",

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Sehestedt, T, Hansen, TW, Li, Y, Richart, T, Boggia, J, Kikuya, M, Thijs, L, Stolarz-Skrzypek, K, Casiglia, E, Tikhonoff, V, Malyutina, S, Nikitin, Y, Bjorklund-Bodegard, K, Kuznetsova, T, Ohkubo, T, Lind, L, Torp-Pedersen, C, Jeppesen, J, Ibsen, H, Imai, Y, Wang, J, Sandoya, E, Kawecka-Jaszcz, K & Staessen, JA 2011, 'Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations', Hypertension Research, vol. 34, no. 6, pp. 714-721. https://doi.org/10.1038/hr.2011.6

TY - JOUR

T1 - Are blood pressure and diabetes additive or synergistic risk factors? Outcome in 8494 subjects randomly recruited from 10 populations

AU - Sehestedt, Thomas

AU - Hansen, Tine W.

AU - Li, Yan

AU - Richart, Tom

AU - Boggia, Jose

AU - Kikuya, Masahiro

AU - Thijs, Lutgarde

AU - Stolarz-Skrzypek, Katarzyna

AU - Casiglia, Edoardo

AU - Tikhonoff, Valerie

AU - Malyutina, Sofia

AU - Nikitin, Yuri

AU - Bjorklund-Bodegard, Kristina

AU - Kuznetsova, Tatiana

AU - Ohkubo, Takayoshi

AU - Lind, Lars

AU - Torp-Pedersen, Christian

AU - Jeppesen, Jorgen

AU - Ibsen, Hans

AU - Imai, Yutaka

AU - Wang, Jiguang

AU - Sandoya, Edgardo

AU - Kawecka-Jaszcz, Kalina

AU - Staessen, Jan A.

PY - 2011/6

Y1 - 2011/6

N2 - It remains unknown whether diabetes and high blood pressure (BP) are simply additive risk factors for cardiovascular outcome or whether they act synergistically and potentiate one another. We performed 24-h ambulatory BP monitoring in 8494 subjects (mean age, 54.6 years; 47.0% women; 6.9% diabetic patients) enrolled in prospective population studies in 10 countries. In multivariable-adjusted Cox regression, we assessed the additive as opposed to the synergistic effects of BP and diabetes in relation to a composite cardiovascular endpoint by testing the significance of appropriate interaction terms. During 10.6 years (median follow-up), 1066 participants had a cardiovascular complication. Diabetes mellitus as well as the 24-h ambulatory BP were independent and powerful predictors of the composite cardiovascular endpoint. However, there was no synergistic interaction between diabetes and 24-h, daytime, or nighttime, systolic or diastolic ambulatory BP (P for interaction, 0.07

AB - It remains unknown whether diabetes and high blood pressure (BP) are simply additive risk factors for cardiovascular outcome or whether they act synergistically and potentiate one another. We performed 24-h ambulatory BP monitoring in 8494 subjects (mean age, 54.6 years; 47.0% women; 6.9% diabetic patients) enrolled in prospective population studies in 10 countries. In multivariable-adjusted Cox regression, we assessed the additive as opposed to the synergistic effects of BP and diabetes in relation to a composite cardiovascular endpoint by testing the significance of appropriate interaction terms. During 10.6 years (median follow-up), 1066 participants had a cardiovascular complication. Diabetes mellitus as well as the 24-h ambulatory BP were independent and powerful predictors of the composite cardiovascular endpoint. However, there was no synergistic interaction between diabetes and 24-h, daytime, or nighttime, systolic or diastolic ambulatory BP (P for interaction, 0.07

KW - ambulatory blood pressure

KW - cardiovascular risk factors

KW - diabetes mellitus

KW - epidemiology

KW - population science

U2 - 10.1038/hr.2011.6

DO - 10.1038/hr.2011.6

M3 - Article

C2 - 21307869

SN - 0916-9636

VL - 34

SP - 714

EP - 721

JO - Hypertension Research

JF - Hypertension Research

IS - 6

ER -