Huang Yu-Qing, Liu Lin, Huang Jia-Yi, Chen Chao-Lei, Yu Yu-Ling, Lo Kenneth, Feng Ying-Qing
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Ann Transl Med. 2020 Dec;8(23):1580. doi: 10.21037/atm-20-1155.
Current recommendations suggest prediabetes testing for overweight or obese adults with at least one cardiovascular risk factor. However, it is important to understand whether testing should be conducted in adults with hypertension regardless of their cardiovascular risk factors.
Participants from the 1999-2014 National Health and Nutrition Examination Surveys (NHANES) aged at least 18 years and without diabetes were enrolled in the study. Participants were classified according to their prediabetes and hypertension status and followed up to track cardiovascular and all-cause mortality until December 31, 2015. Cox proportional hazards models were built to estimate the hazard ratios (HRs). Results were stratified by age, sex, ethnicity, body mass index, and cardiovascular disease history.
At baseline, 5,011 (14.72%) out of 34,047 participants had combined prediabetes and hypertension. Prediabetes alone was not associated with all-cause or cardiovascular mortality. Hypertension alone was significantly associated with all-cause (HR: 1.30) and cardiovascular (HR: 1.89) mortality, and combined prediabetes and hypertension were significantly associated with all-cause (HR: 1.37) and cardiovascular (HR: 2.11) mortality. Age and ethnicity were significantly associated with combined prediabetes and hypertension and all-cause mortality, where the association was stronger among people aged <60 years (HR: 1.94 1.22) and White (HR: 1.50 1.21).
Prediabetes might elevate the risk of all-cause and cardiovascular mortality among people with hypertension. This relationship is more evident among younger and White individuals.
目前的建议是对至少有一个心血管危险因素的超重或肥胖成年人进行糖尿病前期检测。然而，了解无论心血管危险因素如何，是否应对高血压成年人进行检测很重要。
研究纳入了1999 - 2014年国家健康与营养检查调查（NHANES）中年龄至少18岁且无糖尿病的参与者。根据他们的糖尿病前期和高血压状况进行分类，并随访至2015年12月31日，以追踪心血管和全因死亡率。构建Cox比例风险模型来估计风险比（HRs）。结果按年龄、性别、种族、体重指数和心血管疾病史进行分层。
在基线时，34,047名参与者中有5,011名（14.72%）患有糖尿病前期和高血压。单独的糖尿病前期与全因或心血管死亡率无关。单独的高血压与全因（HR：1.30）和心血管（HR：1.89）死亡率显著相关，糖尿病前期和高血压合并存在与全因（HR：1.37）和心血管（HR：2.11）死亡率显著相关。年龄和种族与糖尿病前期和高血压合并存在以及全因死亡率显著相关，其中在<60岁人群（HR：1.94 1.22）和白人（HR：1.50 1.21）中这种关联更强。
糖尿病前期可能会增加高血压患者的全因和心血管死亡风险。这种关系在年轻人和白人中更为明显。
