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Effects of fasting blood glucose, diabetes treatment, blood pressure and anti-hypertension treatment on cardiovascular disease incidence: a 30-year follow-up study of 740 incident patients with Type 2 diabetes
Örebro University Hospital. Family Medicine Research Centre.ORCID iD: 0000-0001-6864-4679
Department of Public Health and Caring Sciences, Family Medicine, Uppsala University, Uppsala, Sweden; Department of Preventive Medicine Section, Uppsala University, Uppsala, Sweden.
Department of Public Health and Caring Sciences, Family Medicine, Uppsala University, Uppsala, Sweden; Department of Preventive Medicine Section, Uppsala University, Uppsala, Sweden.
2013 (English)In: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 30, no 3, p. 349-357Article in journal (Refereed) Published
Abstract [en]

Aims To analyse the effects of hyperglycaemia and blood pressure, diabetes and anti-hypertension treatment on total and various types of cardiovascular disease incidence in patients with Type 2 diabetes followed for 30years.

Methods A total of 740 incident patients with Type 2 diabetes were registered at the Laxa Primary Health Care Centre, Sweden between 1972 and 2001. Information on systolic, diastolic, and mean arterial blood pressure, mean fasting blood glucose, type of diabetes and anti-hypertension treatment was obtained from the patient records, and information on cardiovascular disease, myocardial infarction and stroke events from National Registers.

Results During the follow-up period the cumulative incidence of cardiovascular disease increased significantly with male sex (HR 1.52, 95% CI 1.251.85), age (HR 1.05, 95% CI 1.041.07), year of diabetes onset (HR 1.03, 95% CI 1.011.05), BMI, (HR 1.04, 95% CI 1.021.07), mean arterial blood pressure (HR 1.04, 95% CI 1.021.05) and number of previous cardiovascular disease events (HR 1.15, 95% CI 1.101.21), and decreased significantly with sulfonylurea treatment (HR 0.64, 95% CI 0.490.84), insulin (HR 0.57, 95% CI 0.330.98) and calcium channel blocker treatment (HR, 0.69, 95% CI 0.480.99). Cumulative incidence of myocardial infarction increased significantly with male sex, age, BMI, mean arterial blood pressure, number of previous myocardial infarction events and diuretic treatment, and decreased with metformin treatment. Cumulative incidence of stroke increased with age, year of diabetes onset, mean arterial blood pressure, and previous number of stroke events.

Conclusions Cumulative cardiovascular disease, myocardial infarction and incidence of stroke increased with number of previous events and presence of hypertension and decreased with pharmacological anti-diabetic treatment and, to a lesser extent, with anti-hypertension treatment.

Place, publisher, year, edition, pages
2013. Vol. 30, no 3, p. 349-357
Keywords [en]
Administration, Oral, Aged, Antihypertensive Agents, Blood Glucose, Blood Pressure, Diabetes Mellitus, Type 2, Diabetic Angiopathies, Fasting, Female, Follow-Up Studies, Humans, Hyperglycemia, Hypertension, Hypoglycemic Agents, Male, Middle Aged, Myocardial Infarction, Stroke
National Category
Endocrinology and Diabetes
Research subject
Internal Medicine
Identifiers
URN: urn:nbn:se:oru:diva-38725DOI: 10.1111/dme.12106ISI: 000315339300022PubMedID: 23278364Scopus ID: 2-s2.0-84874187915OAI: oai:DiVA.org:oru-38725DiVA, id: diva2:764219
Note

A corresction was published  23 JUN 2013:  http://dx.doi.org/10.1111/dme.12219

Funding agencies are:

Primary Health Care Research Unit, Orebro,

Orebro County Council Research Unit,

Family Medicine Research Centre, Orebro University Hospital 

Uppsala University 

Available from: 2014-11-18 Created: 2014-11-18 Last updated: 2018-05-22Bibliographically approved

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Jansson, Stefan P. O.

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