机构:[1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China广东省中医院深圳市中医院深圳医学信息中心[2]Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China大德路总院重症医学科大德路总院重症医学科广东省中医院
Both low and high glycated hemoglobin A1c (HbA1c) levels are well-established causal risk factors for all-cause and cardiovascular mortality in the general population and diabetic patients. However, the relationship between HbA1c with all-cause and cardiovascular mortality among patients with hypertension is unclear. We used NHANES data from 1999 to 2014 as the basis for this population-based cohort study. Based on HbA1c levels (HbA1c > 5, HbA1c > 5.5, HbA1c > 6, HbA1c > 6.5, HbA1c > 7%), hypertensive patients were divided into five groups. An analysis of multivariable Cox proportional hazards was conducted based on hazard ratios (HRs) and respective 95% confidence intervals (CIs). The relationship between HbA1c and mortality was further explored using Kaplan-Meier survival curves, restricted cubic spline curves, and subgroup analyses. In addition, 13,508 patients with hypertension (average age 58.55 ± 15.56 years) were included in the present analysis, with 3760 (27.84%) all-cause deaths during a follow-up of 127.69 ± 57.9 months. A U-shaped relationship was found between HbA1c and all-cause and cardiovascular mortality (all p for likelihood ratio tests were 0.0001). The threshold value of HbA1c related to the lowest risk for all-cause and cardiovascular mortality was 5.3% and 5.7%, respectively. Below the threshold value, increased HbA1c levels reduced the risk of all-cause mortality (HR 0.68, 95% CI 0.51-0.90, p = 0.0078) and cardiovascular mortality (HR 0.77, 95% CI 0.57-1.05, p = 0.0969). Inversely, above the threshold value, increased HbA1c levels accelerated the risk of all-cause mortality (HR 1.14, 95% CI 1.11-1.18, p < 0.0001) and cardiovascular mortality (HR 1.22, 95% CI 1.16-1.29, p < 0.0001). In conclusion, A U-shape relationship was observed between HbA1c and all-cause and cardiovascular mortality among hypertensive patients.
基金:
This work was partially supported by the National Natural Scientific Foundation (No.
82004135 to Ruixiang Zeng), the Research Fund for Zhaoyang Talents of Guangdong Provincial
Hospital of Chinese Medicine (No. ZY2022KY03 to Ruixiang Zeng), and the Specific Research
Fund for TCM Science and Technology of Guangzhou Provincial Hospital of Chinese Medicine
(YN10101915 to Minzhou Zhang).
第一作者机构:[1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China[2]Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
通讯作者:
通讯机构:[1]The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510405, China[2]Department of Critical Care Medicine, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China
推荐引用方式(GB/T 7714):
Zeng Ruixiang,Zhang Yuzhuo,Xu Junpeng,et al.Relationship of Glycated Hemoglobin A1c with All-Cause and Cardiovascular Mortality among Patients with Hypertension[J].JOURNAL OF CLINICAL MEDICINE.2023,12(7):doi:10.3390/jcm12072615.
APA:
Zeng Ruixiang,Zhang Yuzhuo,Xu Junpeng,Kong Yongjie,Tan Jiawei...&Zhang Minzhou.(2023).Relationship of Glycated Hemoglobin A1c with All-Cause and Cardiovascular Mortality among Patients with Hypertension.JOURNAL OF CLINICAL MEDICINE,12,(7)
MLA:
Zeng Ruixiang,et al."Relationship of Glycated Hemoglobin A1c with All-Cause and Cardiovascular Mortality among Patients with Hypertension".JOURNAL OF CLINICAL MEDICINE 12..7(2023)