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Diabetes in treated...
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Almgren, Torbjörn,1959Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin,Institute of Medicine, Department of Internal Medicine
(författare)
Diabetes in treated hypertension is common and carries a high cardiovascular risk: results from a 28-year follow-up.
- Artikel/kapitelEngelska2007
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LIBRIS-ID:oai:gup.ub.gu.se/56658
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https://gup.ub.gu.se/publication/56658URI
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https://doi.org/10.1097/HJH.0b013e328122dd58DOI
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
Anmärkningar
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OBJECTIVE: The objective of this study was to analyse predictive factors for development of type 2 diabetes during life-long therapy for hypertension and the alleged additional cardiovascular risk this constitutes. METHODS: The study group (n = 754) comprised the hypertensive subgroup of a randomized population sample of 7500 men, aged 47-54 years, screened for cardiovascular risk factors and followed for 25-28 years. The patients were treated with thiazide diuretics and beta-adrenergic blocking drugs with the addition of hydralazin during the first decade. Calcium antagonists were substituted for hydralazin and, if needed, angiotensin-converting enzyme inhibitors were added when these drugs became available. RESULTS: A total of 148 (20.4%) treated hypertensive patients developed diabetes during 25 years, and in multivariate Cox regression analysis body mass index, serum triglycerides and treatment with beta-blockers were positively related with this complication. New-onset diabetes implied a significantly increased risk for stroke [hazard ratio (HR): 1.67; 95% confidence interval (95% CI): 1.1-2.6; P < 0.05], myocardial infarction (OR: 1.66; 95% CI: 1.1-2.5; P < 0.05) and mortality (OR: 1.42; 95% CI: 1.1-1.9; P < 0.05). The greatest risk for stroke was new-onset diabetes, followed by smoking (OR: 1.46; 95% CI: 1-2.2; P = 0.07) and the greatest risk for myocardial infarction was new-onset diabetes, followed by smoking (HR: 1.64; 95% CI: 1.1-2.4; P < 0.01). The greatest risk for mortality was smoking (HR: 1.73; 95% CI: 1.3-2.2; P < 0.005). Achieved systolic and diastolic blood pressure were not predictive of cardiovascular complications or death. The mean observation time from onset of diabetes mellitus to a first stroke was 9.1 years and to a first myocardial infarction 9.3 years. CONCLUSION: Diabetes in treated hypertensive patients is alarmingly common and carries a high risk for cardiovascular complications and mortality.
Ämnesord och genrebeteckningar
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Antihypertensive Agents
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classification
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therapeutic use
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Blood Pressure
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drug effects
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physiology
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Cardiovascular Diseases
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epidemiology
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Diabetes Mellitus
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epidemiology
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Diabetic Angiopathies
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epidemiology
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Follow-Up Studies
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Humans
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Hypertension
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complications
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drug therapy
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Male
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Medical History Taking
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Middle Aged
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Prevalence
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Risk Factors
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Sweden
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epidemiology
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Wilhelmsen, Lars,1932Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine(Swepub:gu)xwilhl
(författare)
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Samuelsson, Ola,1952Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xsamol
(författare)
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Himmelmann, Anders
(författare)
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Rosengren, Annika,1951Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine(Swepub:gu)xrosan
(författare)
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Andersson, Ove,1943Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin,Institute of Medicine, Department of Internal Medicine(Swepub:gu)xandov
(författare)
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Göteborgs universitetInstitutionen för medicin, avdelningen för invärtesmedicin
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Journal of hypertension25:6, s. 1311-70263-6352
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