Diabetes and 15-year Cardiovascular Mortality in a Chinese Population: Differential Impact of Hypertension and Metabolic Syndrome

BackgroundIt remains unclear if the risk for cardiovascular (CV) mortality in patients with diabetes mellitus (DM) is equivalent to that in patients with a history of cardiac disease in Asian populations. The aims of the present study were to investigate whether or not non-heart disease (HD) DM subjects have a similar risk of CV mortality as HD patients without DM (non-DM HD), and whether or not hypertension (HT) or metabolic syndrome (MS) is a CV mortality marker for diabetic subjects identified from a community-based population.MethodsWe followed 11,058 Chinese people aged ≥ 30 years on Kinmen island for a median of 15.0 years.ResultsThe age-, sex- and smoking-adjusted hazard ratios for CV mortality were 3.56 [95% confidence interval (CI): 1.99–6.36] for DM subjects with HD, 1.64 (95% CI: 1.25–2.16) for DM without HD (non-HD DM) subjects, and 1.63 (95% CI: 1.09–2.44) for non-DM HD patients, when compared with subjects without DM and HD. Among the 827 non-HD DM subjects identified at the baseline survey, the age-, sex- and smoking-adjusted hazard ratios for CV mortality were 2.36 (95% CI: 1.30–4.28) for the presence versus absence of HT, and 1.23 (95% CI: 0.65–2.34) for the presence versus absence of MS.ConclusionNon-HD DM subjects had a similar risk of CV mortality to non-DM HD subjects in this Chinese population. The presence of HT but not MS substantially increased CV mortality risk in the DM subjects.