Abstract
BACKGROUND: We aimed to compare cardiovascular risks among participants with T2DM with and without subsequent HTN and participants with HTN with and without subsequent T2DM. METHODS: From January 1, 2000, to December 31, 2018, we identified 16,236 matched pairs of T2DM participants with and without HTN (T2DM cohorts), 53,509 pairs of HTN participants with and without T2DM (HTN cohorts), and 21,158 pairs of comorbid HTN and T2DM participants with T2DM history or HTN history (comorbid cohorts) from Taiwan's National Health Insurance Research Database. Cox proportional-hazard models were used to calculate the risk of cardiovascular disease. RESULTS: The mean follow-up time of this study was 6.75 years. Mean incident rates of coronary artery disease for T2DM cohorts, HTN cohorts, and comorbid cohorts were 16.80, 23.18, and 31.53 per 1000 person-years, respectively. The adjusted hazard ratios (HRs) (95% confidence intervals [95% CIs]) for incident coronary artery disease, stroke, and heart failure in T2DM participants with versus without HTN were 2.22 (2.07-2.37), 1.19 (1.16-1.23), and 0.92 (0.82-1.02), respectively; the adjusted HRs for HTN participants with versus without T2DM were 1.69 (1.55-1.84), 1.25 (1.21-1.30), and 0.98 (0.93-1.05), respectively; the adjusted HRs for comorbid T2DM and HTN participants with previous T2DM versus previous HTN were 2.78 (2.37-3.27), 1.20 (1.13-1.28), and 0.95 (0.88-1.03), respectively. CONCLUSIONS: This nationwide cohort study demonstrated that both T2DM with subsequent HTN and HTN with subsequent diabetes were associated with higher cardiovascular disease risks.