Raised blood sugar, blood pressure (BP) and blood cholesterol are risk factors often clustered together. However, two new studies from Asia try to disentangle their interactions.

In the Chinese population, blood glucose level within prediabetic range is significantly associated with elevated risks for diabetes mellitus after multi-variable adjustment, but only when it is concurrent with other disorders, such as hypertension, it will significantly increase cardiovascular disease risk. (Qiu et al., 2015).

In the Japanese population, systolic BP was positively associated with ischemic stroke and intra-parenchymal haemorrhage death, and total cholesterol was inversely associated with intra-parenchymal haemorrhage, but no significant interactions between BP and total cholesterol were observed for stroke. High BP and high total cholesterol can synergistically increase the risk for coronary heart disease death but not for stroke in the Asian population (Satoh et al., 2015).

Simple additive risk scores may mislead!

References

Qiu, M., Shen W., Song, X., Ju, L., Tong, W., Wang, H., Zheng, S., Jin, Y., Wu, Y., Wang, W. & Tian, J. (2015) Effects of Prediabetes Mellitus alone or plus Hypertension on Subsequent Occurrence of Cardiovascular Disease and Diabetes Mellitus: Longitudinal Study. Hypertension. 65(3), pp.525-530.

Satoh, M., Ohkubo, T., Asayama, K., Murakami, Y., Sakurai, M., Nakagawa, H., Iso, H., Okayama, A., Miura, K., Imai, Y., Ueshima, H., Okamura, T. on behalf of the Evidence for Cardiovascular Prevention From Observational Cohorts in Japan (EPOCH–JAPAN) Research Group. (2015) Hypertension. 65(3), pp.517-524.