The Impact of Different Antihypertensive Drugs on Cardiovascular Risk in Isolated Systolic Hypertension with Type 2 Diabetes Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Outcome Measurements
2.3. Statistical Analysis
3. Results
3.1. Clinical Characteristics of Patients
3.2. Cardiovascular Outcomes and Mortalities
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Abbreviations
T2DM | Type 2 diabetes mellitus |
BMI | Body Mass Index |
HbA1c | Glycated hemoglobin A1c |
CI | Confidence interval |
ISH | Isolated systolic hypertension |
ARB | Angiotensin receptor blocker |
ACEI | Angiotensin-converting enzyme inhibitor |
CCB | Calcium channel blocker |
TD | Thiazide diuretics |
PO | Primary outcomes |
CM | Cardiovascular mortality |
NMI | Non-fatal myocardial infarction |
NST | Non-fatal stroke |
SBP | Systolic blood pressure |
DBP | Diastolic blood pressure |
CVD | Cardiovascular disease |
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Characteristics | ARB | pValue | ACEI | pValue | ||
(−) | (+) | (−) | (+) | |||
Number | 531 | 531 | 1115 | 1115 | ||
Age, mean (SD) | 64.83 (6.95) | 64.97 (6.74) | 0.741 | 64.55 (6.74) | 64.58 (6.63) | 0.910 |
Female, no. (%) | 273 (51.4) | 254 (47.8) | 0.269 | 496 (44.5) | 458 (41.1) | 0.113 |
Glycated hemoglobin, mean (SD) | 8.11 (0.93) | 8.13 (0.96) | 0.694 | 8.23 (1.04) | 8.24 (0.98) | 0.890 |
BMI, mean (SD) | 32.43 (5.27) | 32.62 (5.52) | 0.570 | 32.16 (5.51) | 32.24 (5.30) | 0.723 |
Smoke lifetime, no. (%) | 243 (45.8) | 245 (46.1) | 0.951 | 547 (49.1) | 546 (49.0) | 1.000 |
Lipid, mean (SD) | ||||||
LDL | 104.79 (33.72) | 101.81 (33.15) | 0.146 | 105.99 (34.18) | 105.55 (33.29) | 0.755 |
HDL | 43.08 (12.34) | 43.15 (12.35) | 0.921 | 43.25 (12.03) | 43.10 (11.77) | 0.726 |
Triglyceride | 183.73 (168.81) | 186.82 (127.36) | 0.737 | 187.71 (135.27) | 186.28 (162.61) | 0.822 |
BP, mean (SD) | ||||||
SBP | 151.93 (10.57) | 151.75 (11.10) | 0.788 | 151.51 (10.53) | 151.91 (10.74) | 0.368 |
DBP | 76.46 (8.25) | 76.25 (8.18) | 0.668 | 76.90 (7.74) | 76.78 (8.10) | 0.724 |
Race, no. (%) | 0.322 | 0.896 | ||||
White | 293 (55.2) | 310 (58.4) | 683 (61.3) | 687 (61.6) | ||
Non-White | 238 (44.8) | 221 (41.6) | 432 (38.7) | 428 (38.4) | ||
Education, no. (%) | 0.700 | 0.261 | ||||
Less than high school | 84 (15.8) | 73 (13.7) | 176 (15.8) | 192 (17.2) | ||
High school | 140 (26.4) | 151 (28.4) | 317 (28.4) | 298 (26.7) | ||
Some college | 178 (33.5) | 172 (32.4) | 373 (33.5) | 346 (31.0) | ||
College degree or higher | 129 (24.3) | 135 (25.4) | 249 (22.3) | 279 (25.0) | ||
Intensive glycemia therapy, no. (%) | 255 (48.0) | 267 (50.3) | 0.500 | 562 (50.4) | 561 (50.3) | 1.000 |
Previous CVD, no. (%) | 192 (32.3) | 194 (36.5) | 0.986 | 379 (34.0) | 402 (36.1) | 0.329 |
Previous heart failure, no. (%) | 21 (4.0) | 20 (3.8) | 0.990 | 35 (3.1) | 48 (4.3) | 0.179 |
Medicines use, no. (%) | ||||||
Sulfonylureas | 271 (51.2) | 255 (48.0) | 0.326 | 553 (49.6) | 568 (50.9) | 0.553 |
Biguanides | 329 (62.2) | 346 (65.2) | 0.347 | 679 (60.9) | 692 (62.1) | 0.602 |
Meglitinide | 14 (2.6) | 11 (2.1) | 0.679 | 28 (2.5) | 33 (3.0) | 0.604 |
Alpha-glucosidase inhibitors | 0 (0.0) | 5 (0.9) | 0.074 | 1 (0.1) | 4 (0.4) | 0.371 |
Thiazolidinediones | 114 (21.6) | 133 (25.0) | 0.203 | 258 (23.1) | 237 (21.3) | 0.308 |
Regular insulins | 80 (15.1) | 84 (15.8) | 0.819 | 141 (12.6) | 160 (14.3) | 0.265 |
Statins | 328 (62.0) | 341 (64.2) | 0.125 | 690 (61.9) | 721 (64.7) | 0.188 |
Characteristics | CCB | pValue | DT | pValue | ||
(−) | (+) | (−) | (+) | |||
Number | 633 | 633 | 806 | 806 | ||
Age, mean (SD) | 65.76 (6.96) | 65.38 (6.64) | 0.321 | 64.86 (6.79) | 64.72 (6.43) | 0.680 |
Female, no. (%) | 260 (41.1) | 267 (42.2) | 0.732 | 360 (44.7) | 363 (45.0) | 0.920 |
Glycated hemoglobin, mean (SD) | 8.19 (0.99) | 8.17 (0.92) | 0.794 | 8.18 (1.00) | 8.19 (0.93) | 0.731 |
BMI, mean (SD) | 32.23 (5.45) | 32.48 (5.56) | 0.404 | 32.57 (5.73) | 32.76 (5.04) | 0.467 |
Smoke lifetime, no. (%) | 307 (48.5) | 293 (46.3) | 0.464 | 362 (44.9) | 382 (47.4) | 0.342 |
Lipid, mean (SD) | ||||||
LDL | 100.32 (31.01) | 102.59(31.87) | 0.205 | 103.00 (33.12) | 103.98 (34.63) | 0.561 |
HDL | 43.45 (12.41) | 43.49 (11.66) | 0.952 | 43.24 (12.46) | 43.04 (11.29) | 0.734 |
Triglyceride | 182.68 (147.30) | 178.13(159.05) | 0.597 | 188.07 (155.43) | 183.87 (129.08) | 0.555 |
BP, mean (SD) | ||||||
SBP | 153.00 (11.73) | 152.40 (10.35) | 0.335 | 152.18 (10.59) | 152.12 (11.10) | 0.916 |
DBP | 75.73 (8.29) | 75.39 (8.51) | 0.472 | 76.55 (7.72) | 76.61 (8.21) | 0.876 |
Race, no. (%) | 0.533 | 0.841 | ||||
White | 353 (55.8) | 365 (57.7) | 450 (55.8) | 445 (55.2) | ||
Non-White | 280 (44.2) | 268 (42.3) | 356 (44.2) | 361 (44.8) | ||
Education, no. (%) | 0.471 | 0.782 | ||||
Less than high school | 117 (18.5) | 120 (19.0) | 132 (16.4) | 128 (15.9) | ||
High school | 184 (29.1) | 184 (29.1) | 233 (28.9) | 231 (28.7) | ||
Some college | 191 (30.2) | 193 (30.5) | 263 (32.6) | 252 (31.3) | ||
College degree or higher | 141 (22.3) | 136 (21.5) | 178 (22.1) | 195 (24.2) | ||
Intensive glycemia therapy, no. (%) | 316 (49.9) | 302 (47.7) | 0.465 | 406 (50.4) | 411 (51.0) | 0.842 |
Previous CVD, no. (%) | 266 (42.0) | 259 (40.9) | 0.732 | 303 (37.6) | 290 (36.0) | 0.535 |
Previous heart failure, no. (%) | 29 (4.6) | 28 (4.4) | 1.000 | 16 (2.0) | 22 (2.7) | 0.412 |
Medicines use, no. (%) | ||||||
Sulfonylureas | 321 (50.7) | 322 (50.9) | 1.000 | 399 (49.5) | 404 (50.1) | 0.842 |
Biguanides | 410 (64.8) | 403 (63.7) | 0.725 | 533 (66.1) | 535 (66.4) | 0.958 |
Meglitinide | 25 (3.9) | 19 (3.0) | 0.443 | 20 (2.5) | 18 (2.2) | 0.870 |
Alpha-glucosidase inhibitors | 3 (0.5) | 3 (0.5) | 1.000 | 1 (0.1) | 1 (0.1) | 1.000 |
Thiazolidinediones | 144 (22.7) | 152 (24.0) | 0.642 | 194 (24.1) | 184 (22.8) | 0.597 |
Regular Insulins | 98 (15.5) | 109 (17.2) | 0.447 | 131 (16.3) | 135 (16.7) | 0.840 |
Statins | 429 (67.8) | 413 (65.2) | 0.372 | 528 (65.5) | 525 (65.1) | 0.917 |
Antihypertensive Therapy | Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | |
ARB (+)/ARB (−) | 0.67 (0.45, 0.99) | 0.047 | 0.66 (0.44, 0.98) | 0.040 | 0.53 (0.34, 0.83) | 0.006 |
ACEI (+)/ACEI (−) | 1.24 (0.95, 1.61) | 0.155 | 1.22 (0.94, 1.59) | 0.126 | 1.19 (0.91, 1.54) | 0.209 |
CCB (+)/CCB (−) | 1.21 (0.86, 1.70) | 0.268 | 1.27 (0.90, 1.78) | 0.173 | 1.23 (0.87, 1.73) | 0.245 |
TD (+)/TD (−) | 0.89 (0.66, 1.23) | 0.508 | 0.90 (0.66, 1.23) | 0.503 | 0.88 (0.64, 1.21) | 0.438 |
Outcomes | Model 1 | Model 2 | Model 3 | |||
---|---|---|---|---|---|---|
HR (95% CI) | p Value | HR (95% CI) | p Value | HR (95% CI) | p Value | |
Cardiovascular mortality | 0.31 (0.15, 0.66) | 0.002 | 0.30 (0.14, 0.64) | 0.002 | 0.32 (0.18, 0.90) | 0.004 |
Non-fatal myocardial infarction | 0.87 (0.53, 1.45) | 0.605 | 0.87 (0.52, 1.44) | 0.576 | 0.89 (0.53, 1.52) | 0.692 |
Non-fatal stroke | 1.01 (0.38, 2.71) | 0.977 | 1.01 (0.38, 2.72) | 0.977 | 1.04 (0.38, 2.84) | 0.933 |
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Gao, M.; Lin, W.; Ma, T.; Luo, Y.; Xie, H.; Cheng, X.; Bai, Y. The Impact of Different Antihypertensive Drugs on Cardiovascular Risk in Isolated Systolic Hypertension with Type 2 Diabetes Patients. J. Clin. Med. 2022, 11, 6486. https://doi.org/10.3390/jcm11216486
Gao M, Lin W, Ma T, Luo Y, Xie H, Cheng X, Bai Y. The Impact of Different Antihypertensive Drugs on Cardiovascular Risk in Isolated Systolic Hypertension with Type 2 Diabetes Patients. Journal of Clinical Medicine. 2022; 11(21):6486. https://doi.org/10.3390/jcm11216486
Chicago/Turabian StyleGao, Ming, Wenrui Lin, Tianqi Ma, Yi Luo, Hejian Xie, Xunjie Cheng, and Yongping Bai. 2022. "The Impact of Different Antihypertensive Drugs on Cardiovascular Risk in Isolated Systolic Hypertension with Type 2 Diabetes Patients" Journal of Clinical Medicine 11, no. 21: 6486. https://doi.org/10.3390/jcm11216486