Optimal control of blood sugar, BP, and AF reduces risk of heart failure: Study
China: Conservative blood sugar control, and rhythm control of atrial fibrillation (AF), in addition to intensive BP control, are crucial for delaying the progression of heart failure in type 2 diabetes, hypertension, and AF patients, according to a recent study. The study is published in the Internal Medicine Journal.
Atrial fibrillation, hypertension and type 2 diabetes mellitus (T2DM) are risk factors for heart failure with preserved ejection fraction (HFpEF). This study by Li Fan, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China, and colleagues examined the effects of the simultaneous control of all 3 conditions on the new‐onset HFpEF in this population.
The study involved 552 patients with T2DM, hypertension and AF sans clinical signs or symptoms of heart failure. They were followed for 5 years to examine the effects of blood sugar control (hemoglobin A1c: < 7.0%, 7.0%‐8.0% and > 8.0%), blood pressure (BP) control (systolic BP: <120 mmHg, 120‐140 mmHg and >140 mmHg) or rhythm versus rate control for AF on new‐onset HFpEF.
Key findings of the study include:
- With a follow‐up of 5 years, the new‐onset HFpEF occurred in 62 of 552 enrolled participants.
- Among the different control level for diabetes, hypertension and AF, the intensive blood glucose (BG) control, poor BP control and rate control of AF had the highest risk of new‐onset HFpEF, and the conservative BG control, intensive BP control and rhythm control of AF had the lowest risk of new‐onset HFpEF.
- Multivariable cox regression analysis showed that both poor BP control (HR: 1.421) and rate control of AF (HR: 1.362) were independently associated with the development of new‐onset HFpEF.
Our findings demonstrate that besides intensive BP control, rhythm control of AF and conservative blood sugar control are crucial factors for delaying the progression of HFpEF among patients with AF, T2DM, and hypertension.
The study, "Optimal management of blood glucose, blood pressure and atrial fibrillation to reduce the risk of heart failure with preserved ejection fraction," is published in the journal Internal Medicine Journal.
DOI: https://doi.org/10.1111/imj.15006
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