Control for multiple risk factors and incident heart failure and mortality in patients with diabetes mellitus: Insights from the Kailuan cohort study

Wenqi Xu, Xinmu Li, Gary Tse, Jeffrey Shi Kai Chan, Shouling Wu, Tong Liu

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)

Abstract

Background: This study evaluated the relationship between controlling multiple risk factors and diabetes-related heart failure and all-cause mortality, and the extent to which the excess risk can be reduced. Methods: 17,676 patients with diabetes and 69,493 matched non-diabetic control subjects were included in the Kailuan study, with a median follow-up of 11.19 years. The risk factor control was defined by the attainment of target values for systolic blood pressure, body mass index, low-density lipoprotein cholesterol, fasting blood glucose, high-sensitive C-reactive protein and smoking. Fine-Gray and Cox models were used to estimate associations between the degree of risk factor control and risk of heart failure and all-cause mortality respectively. Results: Among diabetes patients, there was a gradual reduction in the risk of outcomes as the degree of risk factor control increased. For each additional risk factor that was controlled, there was an associated 16 % decrease in heart failure risk and a 10 % decrease in all-cause mortality risk. Among diabetes patients with ≥5 well-controlled risk factors, the adjusted hazard ratio compared to controls for heart failure and all-cause mortality was 1.25 (95 %CI: 0.99-1.56) and 1.17(95 %CI: 1.05-1.31) respectively. The protective effect of comprehensive risk factor control on the risk of heart failure was more pronounced in men and those using antihypertensive medications. Conclusions: Control for multiple risk factors is associated with reduced heart failure and all-cause mortality risks in a cumulative and sex-specific manner. However, despite optimization of risk factor control, diabetes patients still face increased risks compared to the general population.

Original languageEnglish
Article number102737
JournalCurrent Problems in Cardiology
Volume49
Issue number9
DOIs
Publication statusPublished - Sept 2024

Keywords

  • Diabetes
  • Heart failure
  • Prospective cohort
  • Risk factor

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