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Longitudinal Study of Hypertensive Subjects With Type 2 Diabetes Mellitus

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dc.contributor.author Bahous, Sola Aoun
dc.contributor.author Safar, Michel E.
dc.contributor.author Gnakaméné, Jean-Barthélémy
dc.contributor.author Yannoutsos, Alexandra
dc.contributor.author Thomas, Frédérique
dc.date.accessioned 2019-02-22T11:25:00Z
dc.date.available 2019-02-22T11:25:00Z
dc.date.copyright 2017 en_US
dc.identifier.issn 0194-911X en_US
dc.identifier.uri http://hdl.handle.net/10725/10068
dc.description.abstract Despite adequate glycemic and blood pressure control, treated type 2 diabetic hypertensive subjects have a significantly elevated overall/cardiovascular risk. We studied 244 816 normotensive and 99 720 hypertensive subjects (including 7480 type 2 diabetics) attending medical checkups between 1992 and 2011. We sought to identify significant differences in overall/cardiovascular risk between hypertension with and without diabetes mellitus. Mean follow-up was 12.7 years; 14 050 all-cause deaths were reported. From normotensive to hypertensive populations, a significant progression in overall/cardiovascular mortality was observed. Mortality was significantly greater among diabetic than nondiabetic hypertensive subjects (all-cause mortality, 14.05% versus 7.43%; and cardiovascular mortality, 1.28% versus 0.7%). No interaction was observed between hemodynamic measurements and overall/cardiovascular risk, suggesting that blood pressure factors, even during drug therapy, could not explain the differences in mortality rates between diabetic and nondiabetic hypertensive patients. Using cross-sectional regression models, a significant association was observed between higher education levels, lower levels of anxiety and depression, and reduced overall mortality in diabetic hypertensive subjects, while impaired renal function, a history of stroke and myocardial infarction, and increased alcohol and tobacco consumption were significantly associated with increased mortality. Blood pressure and glycemic control alone cannot reverse overall/cardiovascular risk in diabetics with hypertension. Together with cardiovascular measures, overall prevention should include recommendations to reduce alcohol and tobacco consumption and improve stress, education levels, and physical activity. en_US
dc.language.iso en en_US
dc.title Longitudinal Study of Hypertensive Subjects With Type 2 Diabetes Mellitus en_US
dc.type Article en_US
dc.description.version Published en_US
dc.author.school SOM en_US
dc.author.idnumber 200803754 en_US
dc.author.department N/A en_US
dc.description.embargo N/A en_US
dc.relation.journal Hypertension en_US
dc.journal.volume 69 en_US
dc.journal.issue 6 en_US
dc.article.pages 1029–1035 en_US
dc.keywords Aortic stiffness en_US
dc.keywords Cardiovascular risk en_US
dc.keywords Hypertension en_US
dc.keywords Overall risk en_US
dc.keywords type 2 diabetes mellitus en_US
dc.identifier.doi http://dx.doi.org/10.1161/HYPERTENSIONAHA.116.08962 en_US
dc.identifier.ctation Safar, M. E., Gnakaméné, J. B., Bahous, S. A., Yannoutsos, A., & Thomas, F. (2017). Longitudinal study of hypertensive subjects with type 2 diabetes mellitus: overall and cardiovascular risk. Hypertension, 69(6), 1029-1035. en_US
dc.author.email sola.bahous@lau.edu.lb en_US
dc.identifier.tou http://libraries.lau.edu.lb/research/laur/terms-of-use/articles.php en_US
dc.identifier.url https://www.ahajournals.org/doi/pdf/10.1161/HYPERTENSIONAHA.116.08962 en_US
dc.orcid.id https://orcid.org/0000-0002-7159-7559 en_US
dc.author.affiliation Lebanese American University en_US


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