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Effect of BP reduction on HF risk attenuated by improper glycemic control
Effect of BP reduction on the risk of developing Heart Failure was attenuated with deteriorating glucose tolerance according to a recent study published in the American Heart Journal, 2022.
The toll of Diabetes as a global pandemic continues to grow worldwide. Diabetes when associated with hypertension shows an exaggerated effect and may cause a burden on the heart leading to incident cardiovascular diseases. So, researchers conducted a study to evaluate the clinical benefit of blood pressure (BP) reduction in individuals with diabetes and identify the clinical impact of BP reduction on incident cardiovascular disease in people having diabetes and hypertension.
A retrospective cohort study was conducted on 754,677 individuals with stage 1 and stage 2 hypertension. The mean age of the patients was 47 years with 75,8% being males. Categorization of patients was done using fasting plasma glucose (FPG) at baseline as normal FPG (FPG < 100 mg/dL) having 5,17,372 participants, prediabetes (FPG:100-125 mg/dL) having 1,97,836 participants, or diabetes mellitus (FPG ≥126 mg/dL) having 39,469 participants. The primary measurement outcome was heart failure (HF), and the secondary outcomes included ischemic heart disease (IHD) including myocardial infarction, angina pectoris, and stroke.
Results:
- Over a mean follow-up of 1111±909 days, 18,429 HFs, 17,058 IHDs, and 8,795 strokes were recorded.
- Reduction in BP of< 120/80 mmHg at one year was associated with a lower risk of developing HF, IHD, and stroke in individuals with normal FPG.
- But it was not associated with a risk of developing HF and stroke in those with DM.
- Interaction analyses showed that the influence of BP reduction on incident HF was attenuated in people with prediabetes or DM.
- All the results were confirmed by the multitude of sensitivity analyses.
Thus, the researchers concluded that the risk of developing HF was attenuated with deteriorating glucose tolerance and associated BP reduction. They also added that the management strategy for hypertensive people with prediabetes or DM has to be established for the prevention of developing cardiovascular disease (particularly HF).
To read the full article, click here: https://doi.org/10.1016/j.ahj.2022.07.005
Suzuki Y, Kaneko H, Yano Y, et al. Glycemic status and the association of change in blood pressure with incident cardiovascular disease. American Heart Journal. Published online July 2022.
BDS, MDS
Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751