The impact of diabetes and coronary artery disease on mortality and morbidity in patients with hypertension
Küçük Resim Yok
Tarih
2009
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Hipertansif hastalarda diabetes mellitus (DM) ve/veya koroner arter hastalığının (KAH) kardiyovasküler sonlanım noktaları üzerine etkisi değerlendirildi. Çalışma planı: Kesitsel, çokmerkezli, gözlemsel bir çalışma olan Vasküler Risk Çalışması, Türkiye’nin farklı bölgelerinden 5600 hasta ile yürütülmektedir. Bu çalışma grubunda yer alan hipertansiyonlu 4506 hastadan takipleri yapılan 2664’ü (1643 kadın, 1021 erkek; ortalama yaş: 65.3; dağılım 55-99) değerlendirildi. Beş yıllık takip sonundaki kardiyovasküler birincil ve ikincil sonlanım noktaları, sadece hipertansiyon bulunan hastalarda ve DM ve/veya KAH bulunan hastalarda araştırıldı. Ölüm nedeniyle ilgili bilgi hastaların yakınlarından takip telefonlarıyla elde edildi. Bulgular: İncelenen hastaların 1171’inde (%44) sadece hipertansiyon, 631’inde (%23.7) DM, 530’unda (%19.9) KAH, 332’sinde (%12.5) DM ve KAH vardı. Diyabet ve KAH’den birinin olduğu hastalarda tüm sonlanım noktalarında anlamlı artış görüldü. Birincil ve ikincil sonlanım noktaları, kardiyovasküler ölüm ve tüm nedenli ölümlerin oranları, hipertansiyon yanında sadece DM olan ve sadece KAH olan hastalarda benzer bulundu. Sağkalım analizinde, en düşük kardiyovasküler ölüm oranı sadece hipertansiyon olan hastalarda (%5.7), en yüksek oran ise hem DM hem de KAH olan hastalarda (%18.4) görüldü. Hipertansif grupta sadece DM ve sadece KAH olan hastalarda kümülatif sağkalım oranları benzer bulundu (p>0.05). Sonuç: Bu çalışmada, hipertansif hastalarda DM varlığının oluşturduğu kardiyovasküler riskin, KAH varlığının oluşturduğu riske eşit olduğu ve bunların ikisinin bir arada bulunduğu hipertansif hastalarda riskin geometrik olarak arttığı gösterilmiştir.
Objectives: We evaluated the impact of diabetes mellitus (DM) and/or coronary artery disease (CAD) on cardiovas- cular endpoints in a cohort of hypertensive patients. Study design: the Vascular Risk Study is a cross-sec- tional, multicenter, observational study conducted among 5,600 patients from various regions of Turkey. This analysis included 2,664 patients (1,643 women, 1,021 men; mean age 65.3 years; range 55-99 years) whose follow-up data were adequate among a population of 4,506 hypertensive subjects. Cardiovascular primary and secondary endpoints at the end of a five-year follow-up were assessed in patients who had hypertension alone, and in those having DM and/or CAD. Information on the cause of death was obtained from the relatives of the patients by follow-up phone calls. Results: There were 1,171 patients (44%) with isolated hypertension, 631 (23.7%) with DM, 530 (19.9%) with CAD, and 332 (12.5%) with both DM and CAD. the presence of either DM or CAD was associated with significant increases in the incidences of all endpoints. the occurrences of pri- mary and secondary endpoints, cardiovascular death, and all death were similar in hypertensive patients who had DM without CAD and in patients who had CAD without DM. in survival analysis, the incidence of cardiovascular death was lowest (5.7%) in hypertensive patients without DM and CAD, and highest (18.4%) in hypertensive patients with DM and CAD. the cumulative survival rates were similar in hyperten- sive patients with either DM or CAD alone (p>0.05). Conclusion: This study demonstrated that the level of car- diovascular risk associated with DM was equal to the risk associated with CAD in hypertensive patients and that the coexistence of DM and CAD in these patients increases the risk geometrically.
Objectives: We evaluated the impact of diabetes mellitus (DM) and/or coronary artery disease (CAD) on cardiovas- cular endpoints in a cohort of hypertensive patients. Study design: the Vascular Risk Study is a cross-sec- tional, multicenter, observational study conducted among 5,600 patients from various regions of Turkey. This analysis included 2,664 patients (1,643 women, 1,021 men; mean age 65.3 years; range 55-99 years) whose follow-up data were adequate among a population of 4,506 hypertensive subjects. Cardiovascular primary and secondary endpoints at the end of a five-year follow-up were assessed in patients who had hypertension alone, and in those having DM and/or CAD. Information on the cause of death was obtained from the relatives of the patients by follow-up phone calls. Results: There were 1,171 patients (44%) with isolated hypertension, 631 (23.7%) with DM, 530 (19.9%) with CAD, and 332 (12.5%) with both DM and CAD. the presence of either DM or CAD was associated with significant increases in the incidences of all endpoints. the occurrences of pri- mary and secondary endpoints, cardiovascular death, and all death were similar in hypertensive patients who had DM without CAD and in patients who had CAD without DM. in survival analysis, the incidence of cardiovascular death was lowest (5.7%) in hypertensive patients without DM and CAD, and highest (18.4%) in hypertensive patients with DM and CAD. the cumulative survival rates were similar in hyperten- sive patients with either DM or CAD alone (p>0.05). Conclusion: This study demonstrated that the level of car- diovascular risk associated with DM was equal to the risk associated with CAD in hypertensive patients and that the coexistence of DM and CAD in these patients increases the risk geometrically.
Açıklama
Anahtar Kelimeler
Kalp ve Kalp Damar Sistemi
Kaynak
Türk Kardiyoloji Derneği Arşivi
WoS Q Değeri
Scopus Q Değeri
Cilt
37
Sayı
4
