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Combined effects of blood pressure and glycemic status on risk of heart failure: a population-based study

Ayako Kobayashi1,2, Kazuya Fujihara1, Mayuko Harada Yamada1

  • 1Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata.

Journal of Hypertension
|February 2, 2023
PubMed

Insights

Blood pressure and glycemic status significantly impact heart failure risk. Diabetes with uncontrolled blood pressure, especially low systolic BP, dramatically increases heart failure risk, necessitating comprehensive management.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Heart failure (HF) is a major global health concern.
  • Elevated blood pressure (BP) and diabetes mellitus are significant risk factors for cardiovascular diseases, including HF.

Purpose of the Study:

  • To investigate the combined effects of blood pressure (BP) and glycemic status on the risk of heart failure (HF).

Main Methods:

  • A Japanese claims database (2008-2019) of 589,621 individuals was analyzed.
  • Cox proportional hazards models were used to assess HF incidence across different BP and glucose status categories.

Main Results:

  • Heart failure incidence increased with worsening glycemic status (0.10, 0.18, 0.80 per 1000 person-years for normoglycemia, borderline glycemia, and diabetes, respectively).
  • In individuals with diabetes, low systolic BP (<120 mmHg) was associated with a five-fold increased risk of heart failure compared to those with normoglycemia and similar BP.
  • The relationship between BP and HF risk varied by glycemic status, with a J-shaped association observed for diastolic BP in borderline glycemia and systolic BP in diabetes.

Conclusions:

  • The association between BP and HF risk is modified by glycemic status.
  • In patients with diabetes, aggressive BP lowering, particularly of diastolic BP, requires caution. Comprehensive management of other risk factors is crucial for HF prevention.
  • Further research is needed to guide clinical practice regarding BP management in individuals with abnormal glycemic status.
Abstract

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