High blood sugar predicts CV death in adults with or without hypertension

Age and the presence or absence of hypertension influences the effect of hyperglycaemia on cardiovascular death, suggesting the importance of case-specific risk assessments in middle-aged and older people, according to a study.

A total of 1,513 cardiovascular (CV) death occurred during a median follow-up of 12.4 years. The rates of CV mortality per 1,000 participant-years were 4.01 in normotensive individuals with normal glycaemia, 4.98 in prediabetic adults, 8.33 in diabetic participants, and 8.22, 8.81, and 11.1 in hypertensive people with normal glycaemia, prediabetes, and diabetes, respectively.

Prediabetes significantly correlated with an increased risk of CV death in normotensive individuals (hazard ratio [HR], 1.24, 95 percent confidence interval [CI], 1.02‒1.50) but not in hypertensive participants. Type 2 diabetes (T2D) was also predictive of CV mortality in both normotensive (HR, 1.94, 95 percent CI, 1.55‒2.43) and hypertensive individuals (HR, 1.35, 95 percent CI, 1.13‒1.62).

In stratified analyses, T2D showed no significant effect on CV death in people with hypertension aged 65 years and above.

This retrospective cohort study used data from the Hiroshima Study on Glucose Metabolism and Cardiovascular Diseases. Some 16,564 participants without CV disease (mean age 65.8 years) were included. Of these, 6,179 were normoglycaemic, 3,017 were newly diagnosed with T2D, and 7,368 were prediabetic per the 75-g oral glucose tolerance test.

The authors defined hypertension as the use of antihypertensive medications and/or having a blood pressure of at least 140/90 mm Hg.