Concomitant hypertension induces increased MI risk in prediabetic people

Prediabetic individuals are at increased risk of myocardial infarction (MI), but this risk is largely driven by concomitant hypertension rather than prediabetes itself, suggests a recent study.

The investigators sought to determine whether prediabetes alone or combined with hypertension was a more important predictor for cardiovascular disease. To examine this association, they recruited a total of 85,570 participants (mean age, 58.0 years) without diabetes and no previous MI.

Participants were then divided into groups based on prediabetes status and further stratified according to hypertension status. Cox regression models were used to calculate hazard ratios (HRs) with 95 percent confidence intervals (CIs).

Of the participants, a total of 1,122 developed MI (rate, 1.19 per 1,000 person years) after a mean follow-up of 11.0 years.

The multivariable-adjusted HRs for MI events were 1.06 (95 percent CI, 0.84–1.36) among participants with prediabetes alone, 1.73 (95 percent CI, 1.49–2.00) among those with hypertension alone, and 1.89 (95 percent CI, 1.57–2.27) among those with both prediabetes and hypertension as compared with participants with neither condition.

In addition, no association was observed between prediabetes and an increased risk for MI among those with (HR, 1.11, 95 percent CI, 0.94–1.32) and without (HR, 1.02, 95 percent CI, 0.80–1.20) hypertension.

“The current study indicated that among the Chinese general population, the increased risk of MI associated with prediabetes is largely driven by concomitant hypertension rather than prediabetes per se,” the investigators said.