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02-24-2023 | Risk factors | News

Mortality risk factors vary by age in type 2 diabetes

Author: Eleanor McDermid


medwireNews: Hypertension has the largest impact on mortality risk in younger people with type 2 diabetes, whereas chronic kidney disease (CKD) is a greater threat for older people, shows a population-based study.

In people aged 18–54 years, suboptimal blood pressure had a population-attributable fraction (PAF) of 16.9% for all-cause mortality, followed by CKD and smoking, with PAFs of 13.2% and 11.4%, respectively.

But in the oldest age group (≥75 years), CKD had the largest PAF, of 15.2%, followed by cardiovascular disease and suboptimal bodyweight, with PAFs of 9.2% and 7.1%, respectively.

Andrea Luk (The Chinese University of Hong Kong) and co-researchers note that hypertension is a risk factor for CKD, among other conditions.

Therefore, “[t]he presence of hypertension in young people will contribute to the development and progression of CKD and other chronic medical conditions as the effect of high blood pressure accumulates with advancing age,” they write in PLOS Medicine.

In total, the team looked at three comorbidities and five risk factors, namely CKD, cardiovascular disease, and cancer, plus suboptimal blood pressure, low-density lipoprotein (LDL) cholesterol, glycated hemoglobin, and weight, and current smoking.

Although the younger study participants had lower overall mortality than older people, the eight factors combined had a greater relative impact on their mortality risk, with a PAF of 51.6% compared with 35.3% in those aged 75 years or older.

Nevertheless, the absolute number of deaths linked to these factors was about three times greater in the older than younger people.

All but one of the factors were significantly associated with all-cause mortality risk in the overall study cohort, which comprised 360,202 Hong Kong residents (52.4% men, average age 61.4 years) with type 2 diabetes, during a median 6.0 years of follow-up, during which 44,396 people died.

The exception was suboptimal LDL cholesterol, although this risk factor was significantly associated with cardiovascular mortality.

The researchers say their study findings “add strengths to emerging recommendations on detection and treatment of blood pressure early in the time course of diabetes management.”

They stress that this has “the potential to not only reduce mortality in young people with type 2 diabetes but also prevent downstream adverse health consequences such as the development of CKD in older people.”

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2023 Springer Healthcare Ltd, part of the Springer Nature Group

PLoS Med 2023; 20: e1004173


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