Aims: To analyse the effects of hyperglycaemia and blood pressure, diabetes and hypertension treatment on total and various types of cardiovascular disease (CVD) incidence in patients with type 2 diabetes followed for 30 years.
Methods: 740 incident patients with type 2 diabetes were registered at the Laxå Primary Health Care Centre, Sweden between 1972 and 2001. Annual information on systolic, diastolic, and mean arterial blood pressure (MABP), mean fasting blood glucose (FBG), type of diabetes and hypertension treatment was obtained from the patient records, and information on CVD, myocardial infarction (MI), and stroke events from National Registers.
Results: During the follow-up period cumulative CVD incidence increased significantly with male sex (HR 1.48, 95% CI 1.21-1.82), number of previous CVD events (HR 1.13, 95% CI 1.08-1.18) age (HR 1.05, 95% CI 1.04-1.07), mean FBG (HR 1.05, 96% CI 1.00-1.10) BMI, (HR 1.04, 95% CI 1.01-1.06), MABP (HR 1.02, 95% CI 1.01-1.03), and decreased significantly with metformin treatment (HR 0.58, 95% CI 0.38-0.90) and sulfonylurea (HR 0.73, 95% CI 0.55-0.97). Cumulative MI incidence increased significantly with male sex, number of previous MI events, mean FBG, BMI, age, and MABP, and decreased with metformin treatment. Cumulative stroke incidence increased with previous number of stroke events, age, and MABP.
Conclusions: Cumulative CVD and MI incidence increased with number of previous events and presence of hypertension and hyperglycaemia and decreased with pharmacological diabetic treatment. For stroke, previous number of events increased the incidence but no pharmacological protective effect was seen.