TURNER, RC and HOLMAN, RR and MATTHEWS, DR and BASSETT, PA and COSTER, R and STRATTON, IM and CULL, CA and PETO, R and FRIGHI, V and KENNEDY, IA and MANLEY, SE and BOWN, EG and EELEY, EA and ROSS, I and MATTHEWS, DR and DORNAN, TL and WRIGHT, AD and NEIL, HAW and KOHNER, EM and ALDINGTON, S and KEEN, N and ROSE, C and FLETCHER, AE and BATTERSBY, C and YUDKIN, JS and OAKES, SF and TURNER, RC and HOLMAN, RR and STEARN, MR and PALMER, SL and HAMMERSLEY, MS and FRANKLIN, SI and SPIVEY, RS and HOCKADAY, TDR and MURCHISON, LE and BRUNT, AHE and WILLIAMS, MJ and MACPEARSON, DW and PETRIE, XMP and LEAN, MEJ and WRIGHT, AD and LEVI, NA and SHEARER, ACI and THOMPSON, RJW and KOHNER, EM and DODDRIDGE, MC and HAYES, JR and HENRY, RW and FETHERSTON, MS and HADDEN, DR and KENNEDY, L and ATKINSON, AB and CULBERT, AM and HAGAN, C and SPATHIS, AS and NANSON, ME and JAMES, LM and TYRELL, JM and YUDKIN, JS and GOULD, C and SINGER, J and BADENOCH, M and GREENWOOD, RH and WILSON, J and DENHOLM, MJ and TEMPLE, RC and BORTHWICK, LJ and WHEATCROFT, DJ and SEAMAN, RJ and CHRISTIE, RA and NEWTON, RW and JUNG, RT and ROXBURGH, C and KILGALLAN, B and FOX, CJ and HOLLOWAY, MC and COGHILL, HM and PAISEY, RB and BROWN, NPR and TUCKER, AJ and ROLAND, JM and BROWN, DJ and YOUENS, J and BROWN, PM and DAVIDSON, AJM and PEACOCK, IDA and CULVERWELL, NJC and CHARLTON, MH and CONNOLLY, BPS and BOULTON, AJM and ROBERTSON, AM and YOUNG, RJ and DORNAN, TL and CLYNE, JR and BURDEN, AC and SELLEN, EM and TOOKE, JE (1993) HYPERTENSION IN DIABETES STUDY (HDS) .2. INCREASED RISK OF CARDIOVASCULAR COMPLICATIONS IN HYPERTENSIVE TYPE-2 DIABETIC-PATIENTS. J HYPERTENS , 11 (3) 319 - 325.
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Objective: To determine the degree to which hypertension is a risk factor for macrovascular and microvascular complications in type 2 diabetes.Design: Observational prospective study.Subjects: Newly diagnosed Type 2 diabetic patients recruited into the UK Prospective Diabetes Study (n = 3648; mean age 52 years), 40% of whom were hypertensive (blood pressure greater-than-or-equal-to 160 mmHg systolic and/or greater-than-or-equal-to 90 mmHg diastolic or already being treated for hypertension).Measurements. The incidence of fatal and non-fatal major diabetes- and hypertension-related clinical events was determined over a median of 4.6 years' follow-up. The 3-year change in prevalence of subclinical indices of macrovascular and microvascular disease was assessed, including ECG abnormalities (Minnesota coding), left ventricular hypertrophy (ECG and chest x-ray), microalbuminuria (albumin/creatinine ratio) and moderately severe retinopathy (grading of retinal photographs).Results: The hypertensive patients had (1) a greater incidence than normotensive patients of death from diabetes-related, mainly cardiovascular events (age-adjusted odds ratio 1.82) and (2) a greater incidence of diabetes-related death and major morbidity combined, including myocardial infarctions, angina, strokes and amputation (age-adjusted odds ratio 1.56). These associations were still present after allowance for other risk factors present at the time diabetes was diagnosed. The change in the prevalence of microvascular disease over 3 years was similar in both hypertensive and normotensive subjects.Conclusions: Hypertension is a major risk factor for cardiovascular morbidity and mortality in type 2 diabetes. Comparison with other studies suggests that patients with both hypertension and diabetes have approximately four times the cardiovascular risk of non-diabetic non-hypertensive subjects. Antihypertensive therapy may provide greater benefit in this high-risk group than in the general population.
|Title:||HYPERTENSION IN DIABETES STUDY (HDS) .2. INCREASED RISK OF CARDIOVASCULAR COMPLICATIONS IN HYPERTENSIVE TYPE-2 DIABETIC-PATIENTS|
|Keywords:||TYPE-2 DIABETES, HYPERTENSION, COMPLICATIONS, CARDIOVASCULAR DISEASE, UK PROSPECTIVE DIABETES STUDY, CORONARY-HEART-DISEASE, BLOOD-PRESSURE, RETINOPATHY, MORTALITY, GLUCOSE, IMPACT, TRIALS, STROKE|
|UCL classification:||UCL > School of Life and Medical Sciences|
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