Impact of Blood Pressure on Sudden Cardiac Arrest in Diabetic Patients

Hypertension and diabetes mellitus (DM), including pre-hypertension and impaired fasting glucose (IFG), are associated with increased risk of sudden cardiac arrest (SCA). However, interaction between hypertension and DM needs further examination.

This study utilized data from the South Korean national healthcare insurance system. People who underwent nationwide health screening in 2012 were enrolled. The impact of blood pressure on SCA was evaluated in both diabetic and non-diabetic patients.

A total of 4,593,706 people were analyzed with 3,097,423, 1,034,563, and 461,720 people included in non-DM, IFG, and DM group, respectively. Both high blood pressure (systolic, diastolic, and pulse) and DM were associated with an increased risk of SCA with the highest absolute risk observed in patients with both conditions. A significant interaction was found between blood pressure and DM (P for interaction <0.01): the relative influence of blood pressure on SCA risk was greater in the non-diabetic population. Importantly, in diabetic patients, a J-shaped association was observed; not only high but also low systolic blood pressure (<100 mm Hg) was associated with a significantly increased risk of SCA.

Although the risk of SCA was highest in people with both hypertension and DM, the degree of association between blood pressure and SCA was more pronounced in non-diabetic people. In patients with diabetes, both high and low systolic blood pressure are associated with an elevated risk of SCA. While controlling hypertension is crucial for all individuals, avoiding hypotension may be another important strategy for preventing SCA in diabetic population.