Pyo Won Kyung, Kim Hee-Jung, Han Kyungdo, Kim Jin Nam, Lee Se Ju, Kim Jung Ho, Ku Nam Su, Lee Seung Hyun
Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Korea University College of Medicine, 222, Korea-daero, Seongbuk-gu, Seoul, 02841, Republic of Korea.
Clin Hypertens. 2024 Dec 1;30(1):37. doi: 10.1186/s40885-024-00295-4.
We aimed to assess the incidence of infective endocarditis (IE) and evaluate the impact of hypertension (HTN) with underweight on the risk of IE among patients with diabetic mellitus (DM) using a nationwide population-based cohort in Korea.
We identified 2,603,012 participants (57.4 ± 12.3 years) in the national health insurance database. Of these, 374,586 were normotensive, 750,006 were at pre-HTN status, and the remainder had HTN. The risk of IE was compared between the groups, and the impact of being underweight (body mass index < 18.5) was also evaluated.
During follow-up (7.14 years; interquartile range 6.01-8.08 years), 1,703 cases of IE occurred; 168 (0.0647 person per 1000 person-years [PY]), 303 (0.05836 per 1000 PY), and 1,232 (0.12235 per 1000 PY) in normotensive, pre-HTN and HTN group, respectively. Hypertensive participants presented a higher risk of IE (subdistribution hazard ratio, 1.360; 95% confidence interval, 1.152-1.607) than normotensive participants. Being underweight increased the risk of IE by 90% among subjects with HTN. In subgroup analysis, age, duration of DM, insulin use, and habitual factors were not associated with the incidence of IE.
Diabetic patients may require rigorous blood pressure control and simultaneous avoidance of excessive weight loss to prevent IE.
我们旨在利用韩国全国性基于人群的队列，评估感染性心内膜炎（IE）的发病率，并评估高血压（HTN）合并体重过轻对糖尿病（DM）患者发生IE风险的影响。
我们在国家健康保险数据库中确定了2603012名参与者（年龄57.4±12.3岁）。其中，374586人血压正常，750006人处于高血压前期状态，其余患有高血压。比较了各组发生IE的风险，并评估了体重过轻（体重指数<18.5）的影响。
在随访期间（7.14年；四分位间距6.01 - 8.08年），发生了1703例IE；血压正常组、高血压前期组和高血压组分别为168例（每1000人年0.0647人）、303例（每1000人年0.05836人）和1232例（每1000人年0.12235人）。高血压参与者发生IE的风险（亚分布风险比，1.360；95%置信区间，1.152 - 1.607）高于血压正常的参与者。体重过轻使高血压患者发生IE的风险增加90%。在亚组分析中，年龄、DM病程、胰岛素使用和习惯因素与IE的发病率无关。
糖尿病患者可能需要严格控制血压并同时避免过度体重减轻以预防IE。
