{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T18:26:17Z","timestamp":1790101577597,"version":"4.0.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,1,3]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Hypertension and diabetes frequently coexist. However, little is known about the interaction between high blood pressure (BP) and hyperglycemia in the development of cardiovascular disease (CVD).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">We conducted an observational cohort study that included 3\u2009336\u2009363 patients (median age, 43\u2009years old; men, 57.2%). People taking BP\u2010 or glucose\u2010lowering medications or those with prior history of CVD were excluded. We defined stage 1 hypertension as having systolic BP of 130 to 139\u2009mm\u2009Hg or diastolic BP of 80 to 89\u2009mm\u2009Hg and stage 2 hypertension as having systolic BP of \u2265140\u2009mm\u2009Hg or diastolic BP of \u226590\u2009mm\u2009Hg. We defined prediabetes as having fasting plasma glucose of 100 to 125\u2009mg\/dL and diabetes as having fasting plasma glucose of \u2265126\u2009mg\/dL. Over a mean follow\u2010up period of 1185\u00a0\u00b1\u2009942\u2009days, 5665 myocardial infarction, 52\u2009475 angina pectoris, 25\u2009436 stroke, 54\u2009508 heart failure, and 12\u2009932 atrial fibrillation events occurred. The BP and fasting plasma glucose categories additively increased the risk of myocardial infarction, angina pectoris, stroke, heart failure, and atrial fibrillation. However, the relative risk of stage 1 and stage 2 hypertension developing into CVD was attenuated with deteriorating glycemic status. Similarly, the relative risk of prediabetes and diabetes developing into CVD was attenuated with increasing BP. For example, the relative risk reduction of stage 2 hypertension for heart failure was 53.5% in individuals with normal fasting plasma glucose, 46.4% in those with prediabetes, and 37.2% in those with diabetes. The robustness of our findings was confirmed using a multitude of sensitivity analyses.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Although hypertension and hyperglycemia additively increase the risk of developing CVD, the relative contribution of hypertension to the development of CVD decreased with deteriorating glycemic status and that of hyperglycemia was attenuated with increasing BP. Our results indicate a potential interaction between hypertension and hyperglycemia in the development of CVD.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.026192","type":"journal-article","created":{"date-parts":[[2022,12,24]],"date-time":"2022-12-24T10:30:18Z","timestamp":1671877818000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Interaction of Blood Pressure and Glycemic Status in Developing Cardiovascular Disease: Analysis of a Nationwide Real\u2010World Database"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9406-4691","authenticated-orcid":false,"given":"Yuta","family":"Suzuki","sequence":"first","affiliation":[{"name":"The Department of Cardiovascular Medicine The University of Tokyo Tokyo Japan"},{"name":"Center for Outcomes Research and Economic Evaluation for Health National Institute of Public Health Saitama 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