Persistent Statin Use Shows Increase of Risk Diabetes for Obstructive Sleep Apnea, Hypertension Patients
Hypertension and obstructive sleep apnea are considered independent risk factors for cardiovascular diseases as well as diabetes.
Continuous use of statins for patients with obstructive sleep apnea (OSA) and hypertension increases the risk of diabetes, according to data published in Diabetology and Metabolic Syndrome. Diabetes is considered one of the major risk factors of cardiovascular disease, showing that the 2 are linked, according to the American Heart Association.1,2
Hypertension and obstructive sleep apnea are considered independent risk factors for cardiovascular diseases as well as diabetes. | Image Credit: harlequin9 - stock.adobe.com
Patients with type 2 diabetes (T2D) are more likely to develop and die from cardiovascular disease, resulting in approximately twice as many deaths in people with diabetes as than those without the disease, according to the American Diabetes Association. Further, patients with T2D may have high blood pressure, abnormal cholesterol and high triglycerides, obesity, or lack of physical activity—all contributing to the development of cardiovascular disease. Further, the authors of the current study state that hypertension and OSA are independent risk factors for cardiovascular diseases as well as diabetes.1-3
In recent studies, statins have shown a potential increase in the risk of diabetes, according to the authors of the current study. However, there have been data to suggest a potential decrease. Therefore, investigators conducted a longitudinal study to determine the association between statin use and new-onset diabetes for patients with hypertension and OSA.1
Patients included were 18 years and older with a hypertension and OSA discharge diagnosis from the People’s Hospital of Xinjiang Uygur Autonomous Region, China. Investigators excluded those with a history of diabetes, Cushing syndrome, malignant tumors, usage of steroid medication, or incomplete data. Data included demographics such as age, sex, waist, systolic and diastolic blood pressure, body mass index, smoking status, alcohol intake, hypertension duration, and biochemical measurements relevant to diabetes and cardiovascular disease. The main outcome was a new diabetes diagnosis during follow-up.1
There was a total of 8755 patients with hypertension and OSA at baseline, with 6727 being included and 5390 completing follow-up. The median age was 49 years, and approximately 70.9% were men. During a median of 31 months follow-up, 740 patients developed new-onset diabetes, equating to an incidence of 53.1 per 1000 person-years, according to the study authors. Per 1000 person-years, the incidence of patients not using statins, using statins intermittently, and continuing statins was 48.6, 48.9, and 78.1, respectively. For the sensitivity analysis, investigators excluded patients with a prediabetes diagnosis, finding that the per 1000 person-years were 41.4, 35.8, and 57.7, respectively.1
The risk of diabetes was significantly increased for those who continued to use statins, but there were no significant differences for those taking statins intermittently. When further adjusting for other factors, such as fasting blood glucose, hypertension duration, systolic blood pressure, triglycerides, and age, the results were consistent, showing that continued use of stations could increase the risk of diabetes. When stratifying by gender, both males and females had a higher risk of new-onset diabetes with persistent statin use. Furthermore, this was seen for patients less than 45 years and 45 to 60 years, but not for those older than 60. However, investigators state this could be due to sample size.1
“Statins therapy was significantly associated with new-onset diabetes in patients with hypertension and OSA after adjustment for multiple confounding variables,” the study authors concluded.1 “Therefore, attention should be paid to glycemic control when using statins in this population, and clinicians need to be more cautious when selecting statins.”
READ MORE: Diabetes Resource Center
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