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Hypertension combined with atherosclerosis increases the risk of heart failure in patients with diabetes

Hypertension Research volume 47, pages 921–933 (2024)Cite this article

Abstract

The increase in heart failure risk in the diabetic population when hypertension and atherosclerosis are both present is still inconclusive. The aim of this study was to explore the effects of hypertension combined with atherosclerosis in diabetic population on the risk of heart failure. We selected 10,711 patients with diabetes who participated in the Kailuan study and completed brachial-ankle pulse wave velocity (baPWV) testing for statistical analysis. The subjects were divided into the non-hypertensive non-atherosclerotic, hypertensive, atherosclerotic, and hypertensive atherosclerotic groups based on their history of hypertension and atherosclerosis. At a median follow-up of 4.15 years, 227 cases of heart failure occurred. Compared with the non-hypertensive non-atherosclerotic group, the multifactorial Cox proportional risk regression model showed that the hazard ratio (HR) for heart failure in the hypertensive atherosclerotic group was 3.08 (95% confidence interval [CI]: 1.32–7.16), whereas the HR decreased to 2.38 (95% CI: 1.01–5.63) after gradual correction of lipid-lowering, glucose-lowering, and antihypertensive drugs. The subgroup analysis and sensitivity analysis were consistent with that of total population. In conclusion, patients with diabetes exposed to both hypertension and atherosclerosis had an increased heart failure risk, which was attenuated by the use of lipid-lowering, glucose-lowering, and antihypertensive drugs.

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Acknowledgements

We thank all study participants, their relatives, the members of the survey teams at the 11 regional hospitals of the Kailuan Medical Group; and the project development and management teams at the Shanghai General Hospital and the Kailuan Group.

Funding

The work for this article was supported by National Natural Scientifc Funding of China (No 82070335 & No 81570293) and the National Key R&D Program (2020YFC2004703).

Author information

Author notes

  1. These authors contributed equally: Lili Wu, Jingli Gao, Jinqiang Zhuang

Authors and Affiliations

  1. Department of Cardiology, Shanghai Songjiang District Central Hospital, Shanghai, China

    Lili Wu

  2. Department of Intensive Care Unit, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China

    Jingli Gao

  3. Emergency Intensive Care Unit, The Affiliated Hospital of Yangzhou University, Yangzhou, China

    Jinqiang Zhuang

  4. Department of Emergency and Critical Care Medicine, Shanghai Songjiang District Central Hospital, Shanghai, China

    Meimei Wu

  5. Department of Cardiology, Kailuan General Hospital, North China University of Science and Technology, Tangshan, China

    Shuohua Chen, Guodong Wang & Shouling Wu

  6. West China Hospital, West China School of Medicine, Sichuan University, Chengdu, China

    Linge Hong

  7. Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Jiang Hong

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  1. Lili Wu
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Contributions

LW conducted the statistical analysis, interpreted the data and drafted the manuscript. JG performed the experiments and interpreted the data. JZ revising the manuscript for intellectual content. MW, SC, GW and LH interpreted the data. Shouling Wu, and Jiang Hong had full access to all the data and take responsibility for the integrity of the data and the accuracy of the data analysis.

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Correspondence to Shouling Wu or Jiang Hong.

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Wu, L., Gao, J., Zhuang, J. et al. Hypertension combined with atherosclerosis increases the risk of heart failure in patients with diabetes. Hypertens Res 47, 921–933 (2024). https://doi.org/10.1038/s41440-023-01529-y

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