Background
Methods
Data sources
Study design and definition of the study population
Comorbidities
Characteristics | DM participants | SMD | |||
---|---|---|---|---|---|
Non-HTN (n = 16,236) | HTN (n = 16,236) | ||||
N | % | n | % | ||
Age, years | |||||
20–40 | 2087 | 12.85 | 2000 | 12.32 | 0.01 |
40–60 | 9803 | 60.38 | 9918 | 61.09 | 0.01 |
60–80 | 4346 | 26.77 | 4318 | 26.60 | 0.003 |
Mean ± SD | 53.25 ± 11.92 | 53.32 ± 11.82 | 0.006 | ||
Gender | |||||
Female | 7507 | 46.24 | 7440 | 45.82 | 0.008 |
Male | 8729 | 53.76 | 8796 | 54.18 | 0.008 |
Obesity | |||||
Overweight | 43 | 0.26 | 38 | 0.23 | 0.006 |
Obesity | 270 | 1.66 | 239 | 1.47 | 0.01 |
Severe obesity | 61 | 0.38 | 56 | 0.34 | 0.005 |
Smoking | 343 | 2.11 | 311 | 1.92 | 0.01 |
Comorbidity | |||||
Dyslipidemia | 8796 | 54.18 | 9078 | 55.91 | 0.03 |
CKD | 634 | 3.9 | 681 | 4.19 | 0.01 |
COPD | 2975 | 18.32 | 3049 | 18.78 | 0.01 |
Liver cirrhosis | 486 | 2.99 | 502 | 3.09 | 0.005 |
PAOD | 333 | 2.05 | 350 | 2.16 | 0.007 |
CCI score | |||||
0 | 6383 | 39.31 | 6099 | 37.56 | 0.03 |
1 | 4972 | 30.62 | 5132 | 31.61 | 0.02 |
≥ 2 | 4881 | 30.06 | 5005 | 30.83 | 0.01 |
DCSI score | |||||
0 | 7397 | 45.56 | 7294 | 44.92 | 0.01 |
1 | 3057 | 18.83 | 3141 | 19.35 | 0.01 |
≥ 2 | 5782 | 35.61 | 5801 | 35.73 | 0.002 |
Antidiabetic drugs | |||||
Metformin | 5874 | 36.18 | 5967 | 36.75 | 0.01 |
Sulphonylurea | 5391 | 33.20 | 5596 | 34.47 | 0.05 |
Thiazolidinedione | 1197 | 7.37 | 1245 | 7.67 | 0.01 |
DPP-4 inhibitors | 624 | 3.84 | 602 | 3.71 | 0.007 |
α-glucosidase inhibitor | 1166 | 7.18 | 1234 | 7.60 | 0.012 |
Number of antidiabetic drugs | |||||
0–1 | 11,686 | 71.98 | 11,569 | 71.26 | 0.01 |
2–3 | 4180 | 25.75 | 4295 | 26.45 | 0.011 |
≥ 3 | 370 | 2.28 | 372 | 2.29 | 0.008 |
Insulin | 4561 | 28.09 | 4718 | 29.06 | 0.02 |
Other drug | |||||
Statin | 3673 | 22.62 | 3762 | 23.17 | 0.01 |
DM duration, year | 3.72 ± 3.26 | 3.78 ± 3.84 | 0.01 |
Characteristics | HTN participants | SMD | |||
---|---|---|---|---|---|
Non-DM (n = 53,509) | DM (n = 53,509) | ||||
N | % | n | % | ||
Age, years | |||||
20–40 | 4923 | 9.20 | 4555 | 8.51 | 0.03 |
40–60 | 28,831 | 53.88 | 30,124 | 56.30 | 0.04 |
60–80 | 19,755 | 36.92 | 18,830 | 35.19 | 0.02 |
Mean ± SD | 56.48 ± 12.81 | 56.20 ± 11.71 | 0.01 | ||
Gender | |||||
Female | 25,549 | 47.75 | 25,531 | 47.71 | 0.001 |
Male | 27,960 | 52.25 | 27,978 | 52.29 | 0.001 |
Obesity | |||||
Overweight | 75 | 0.14 | 81 | 0.15 | 0.002 |
Obesity | 695 | 1.30 | 743 | 1.39 | 0.007 |
Severe obesity | 152 | 0.28 | 146 | 0.27 | 0.002 |
Smoking | 824 | 1.54 | 856 | 1.60 | 0.005 |
Comorbidity | |||||
Dyslipidemia | 24,512 | 45.80 | 24,907 | 46.55 | 0.01 |
CKD | 2187 | 4.09 | 2318 | 4.33 | 0.01 |
COPD | 10,096 | 18.87 | 10,785 | 20.16 | 0.03 |
Liver cirrhosis | 826 | 1.54 | 889 | 1.66 | 0.01 |
PAOD | 1079 | 2.02 | 1093 | 2.04 | 0.001 |
CCI score | |||||
0 | 22,517 | 42.08 | 21,167 | 39.56 | 0.05 |
1 | 16,583 | 30.99 | 17,398 | 32.51 | 0.03 |
≥ 2 | 14,409 | 26.93 | 14,944 | 27.93 | 0.02 |
Antihypertensive drugs | |||||
ACEI/ARB | 26,416 | 49.37 | 26,930 | 50.33 | 0.01 |
β-blockers | 25,418 | 47.50 | 26,475 | 49.48 | 0.03 |
Calcium-channel blockers | 28,200 | 52.70 | 28,960 | 54.12 | 0.02 |
Diuretics | 19,473 | 36.39 | 20,124 | 37.61 | 0.02 |
Number of antihypertensive drugs | |||||
0–1 | 22,709 | 42.44 | 21,851 | 40.84 | 0.03 |
2–3 | 24,681 | 46.12 | 24,241 | 45.30 | 0.01 |
≥ 3 | 6119 | 11.44 | 7417 | 13.86 | 0.04 |
Other drug | |||||
Statin | 9976 | 18.64 | 10,523 | 19.67 | 0.02 |
Aspirin | 9721 | 18.17 | 10,069 | 18.82 | 0.01 |
HTN duration, year | 3.81 ± 3.29 | 3.91 ± 3.86 | 0.02 |
Characteristics | DM and HTN participants | SMD | |||
---|---|---|---|---|---|
With previous HTN (n = 21,158) | With previous DM (n = 21,158) | ||||
N | % | N | % | ||
Age, years | |||||
20–40 | 1368 | 6.47 | 1483 | 7.01 | 0.02 |
40–60 | 11,131 | 52.61 | 10,945 | 51.73 | 0.01 |
60–80 | 8659 | 40.93 | 8730 | 41.26 | 0.006 |
Mean ± SD | 57.61 ± 11.85 | 57.50 ± 11.92 | 0.01 | ||
Gender | |||||
Female | 10,106 | 47.76 | 10,114 | 47.8 | 0.008 |
Male | 11,052 | 52.24 | 11,044 | 52.2 | 0.008 |
Obesity | |||||
Overweight | 33 | 0.16 | 37 | 0.17 | 0.004 |
Obesity | 189 | 0.89 | 214 | 1.01 | 0.01 |
Severe obesity | 41 | 0.19 | 49 | 0.23 | 0.008 |
Smoking | 243 | 1.15 | 266 | 1.26 | 0.01 |
Comorbidity | |||||
Dyslipidemia | 10,059 | 52.27 | 11,185 | 52.86 | 0.01 |
CKD | 951 | 4.49 | 1035 | 4.89 | 0.01 |
COPD | 4097 | 19.36 | 1079 | 19.28 | 0.00 |
Liver cirrhosis | 520 | 2.45 | 793 | 3.74 | 0.01 |
PAOD | 467 | 2.21 | 489 | 2.31 | 0.007 |
DCSI score | |||||
0 | 10,277 | 48.57 | 7989 | 37.76 | 0.01 |
1 | 2376 | 11.23 | 3016 | 14.25 | 0.01 |
≥ 2 | 8505 | 40.20 | 10,153 | 47.99 | 0.02 |
CCI score | |||||
0 | 10,433 | 49.31 | 9134 | 43.17 | 0.21 |
1 | 6055 | 28.62 | 6515 | 30.79 | 0.09 |
≥ 2 | 4670 | 22.07 | 5509 | 26.04 | 0.15 |
Antidiabetic drugs | |||||
Metformin | 3418 | 16.15 | 7344 | 34.71 | 0.44 |
Sulphonylurea | 3068 | 14.50 | 7582 | 35.84 | 0.51 |
Thiazolidinedione | 165 | 0.78 | 1601 | 7.57 | 0.34 |
DPP-4 inhibitors | 123 | 0.58 | 548 | 2.59 | 0.16 |
α-glucosidase inhibitor | 290 | 1.37 | 1471 | 6.95 | 0.28 |
Number of antidiabetic drugs | |||||
0–1 | 19,716 | 93.18 | 15,170 | 71.70 | 0.58 |
2–3 | 1435 | 6.78 | 5543 | 26.2 | 0.54 |
≥ 3 | 7 | 0.03 | 445 | 2.10 | 0.2 |
Insulin | 4440 | 20.98 | 5388 | 25.47 | 0.1 |
Antihypertensive drugs | |||||
ACEI/ARB | 9753 | 46.10 | 6384 | 30.17 | 0.33 |
β-blockers | 9687 | 45.78 | 5509 | 26.04 | 0.42 |
Calcium-channel blockers | 10,140 | 47.93 | 5757 | 27.21 | 0.44 |
Diuretics | 7041 | 33.28 | 4137 | 19.55 | 0.43 |
Number of antihypertensive drugs | |||||
0–1 | 9843 | 46.52 | 15,407 | 72.82 | 0.55 |
2–3 | 9122 | 43.11 | 5503 | 26.01 | 0.36 |
≥ 3 | 2193 | 10.36 | 248 | 1.17 | 0.40 |
Other drug | |||||
Statin | 4065 | 19.21 | 4090 | 19.33 | 0.003 |
Aspirin | 2678 | 12.66 | 2836 | 13.40 | 0.02 |
HTN duration, year | 3.45 ± 3.41 | – | |||
DM duration, year | – | 3.42 ± 3.24 |
Main outcomes
Statistical analysis
Results
Baseline characteristics
Main outcomes
Outcomes | DM participants | Crude HR (95% CI) | Adjusted HRa (95% CI) | |||||
---|---|---|---|---|---|---|---|---|
Without HTN (n = 16,236) | With HTN (n = 16,236) | |||||||
Events | PY | IR | Events | PY | IR | |||
CAD | 1353 | 124,027 | 10.91 | 2514 | 110,871 | 22.68 | 2.21 (2.07–2.38) | 2.22 (2.07–2.37) |
Stroke | 863 | 126,799 | 6.81 | 1349 | 119,087 | 11.33 | 1.64 (1.50–1.78) | 1.69 (1.55–1.84) |
Heart failure | 208 | 130,144 | 1.60 | 564 | 123,184 | 4.58 | 2.82 (2.40–3.31) | 2.78 (2.37–3.27) |
Outcomes | HTN participants | Crude HR (95% CI) | Adjusted HRb (95% CI) | |||||
---|---|---|---|---|---|---|---|---|
Without DM (n = 53,509) | With DM (n = 53,509) | |||||||
Events | PY | IR | Events | PY | IR | |||
CAD | 8540 | 403,982 | 21.14 | 9690 | 384,191 | 25.22 | 1.18 (1.15–1.22) | 1.19 (1.16–1.23) |
Stroke | 5236 | 431,530 | 12.13 | 6081 | 415,229 | 14.64 | 1.20 (1.16–1.25) | 1.25 (1.21–1.30) |
Heart failure | 1796 | 453,406 | 3.96 | 2040 | 442,778 | 4.61 | 1.16 (1.09–1.24) | 1.20 (1.13–1.28) |
Outcomes | Coexisted DM and HTN participants | Crude HR (95% CI) | Adjusted HRc (95% CI) | |||||
---|---|---|---|---|---|---|---|---|
Previous HTN (n = 21,158) | Previous DM (n = 21,158) | |||||||
Events | PY | IR | Events | PY | IR | |||
CAD | 4962 | 157,525 | 31.50 | 4847 | 153,584 | 31.56 | 0.99 (0.85–1.03) | 0.92 (0.82–1.02) |
Stroke | 3099 | 174,743 | 17.73 | 3374 | 167,244 | 20.17 | 1.12 (1.07–1.18) | 0.98 (0.93–1.05) |
Heart failure | 1196 | 189,855 | 6.30 | 1319 | 181,499 | 7.27 | 1.16 (1.08–1.25) | 0.95 (0.88–1.03) |