AI Article Synopsis
- This study aimed to explore how blood pressure (BP) and glucose levels affect the risk of heart failure among individuals in Japan from 2008 to 2019.
- Researchers analyzed data from over 589,000 people and found that heart failure incidence increased with higher blood pressure levels, especially in those with diabetes, where the risk was notably higher for patients with low blood pressure.
- The investigators concluded that managing blood pressure might not be enough to prevent heart failure in those with poor glucose management, and they suggested that more comprehensive care is necessary for these patients, along with further research to confirm their findings.
Article Abstract
Aims: To investigate the combined effects of blood pressure (BP) and glycemic status on the risk of heart failure.
Methods: Examined was a Japanese claims database from 2008 to 2019 on 589 621 individuals. Cox proportional hazards model identified the incidence of heart failure among five levels of SBP/DBP according to glucose status.
Results: Mean follow-up period was 5.6 years. The incidence of heart failure per 1000 person-years in the normoglycemia, borderline glycemia, and diabetes groups were 0.10, 0.18, and 0.80, respectively. In normoglycemia, a linear trend was observed between both SBP and DBP categories and hazard ratios for heart failure ( P for linearity <0.001). In borderline glycemia, J-shaped association was observed between DBP categories and hazard ratios, although the liner trend was significant ( P < 0.001). In diabetes, the linear trend for the relationship between DBP categories and hazard ratios was not significant ( P = 0.09) and the J-shaped association in relation to the hazard ratios was observed between SBP categories and heart failure risk. In the lowest SBP category (i.e. SBP < 120 mmHg), patients with diabetes had more than five-fold heart failure risk [hazard ratio (95% confidence interval), 5.10 (3.19-8.15)], compared with those with normoglycemia and SBP less than 120 mmHg.
Conclusion: The association between SBP/DBP and heart failure risk weakened with worsening of glucose metabolism, suggesting strict BP control accompanied by excessively lowered DBP should be cautious in prevent heart failure in abnormal glycemic status. Particularly in diabetes, comprehensive management of risk factors other than BP may be essential to prevent heart failure. Further trials are needed to support these suggestions and apply them to clinical practice.
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Source |
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| http://dx.doi.org/10.1097/HJH.0000000000003362 | DOI Listing |
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