Imperial College London
Portrait Picture

ProfessorJenniferQuint

Faculty of Medicine, School of Public Health

Professor of Respiratory Epidemiology
 
 
 
//

Contact

 

+44 (0)20 7594 8821j.quint

 
 
//

Location

 

.922Sir Michael Uren HubWhite City Campus

//

Summary

 

Publications

Citation

BibTex format

@article{Ngaosuwan:2021:clinem/dgab063,
author = {Ngaosuwan, K and Johnston, DG and Godsland, IF and Cox, J and Majeed, A and Quint, JK and Oliver, N and Robinson, S},
doi = {clinem/dgab063},
journal = {Journal of Clinical Endocrinology and Metabolism},
pages = {1284--1293},
title = {Cardiovascular disease in patients with primary and secondary adrenal insufficiency and the role of comorbidities},
url = {http://dx.doi.org/10.1210/clinem/dgab063},
volume = {106},
year = {2021}
}
Download

RIS format (EndNote, RefMan)

TY  - JOUR
AB  - CONTEXT: Mortality studies have established that cardiovascular disease is the leading cause of death in patients with adrenal insufficiency and the risk is greater than that observed in individually-matched controls. OBJECTIVE: Here we have performed a detailed analysis of cardiovascular morbidity and mortality, taking account of the role of co-morbidities. DESIGN: Retrospective cohort study. SETTING: UK general practitioner database (CPRD). PARTICIPANTS: 6821 patients with adrenal insufficiency (primary, 2052; secondary, 3948) compared with 67564 individually-matched controls, with and without adjustment for comorbidities (diabetes, hypertension, dyslipidaemia, previous cardiovascular disease, and smoking). MAIN OUTCOME MEASURES: Composite cardiovascular events recorded in CPRD and cardiovascular mortality in those participants with linked national mortality data. RESULTS: Hazard ratios (95%CI) for composite cardiovascular events in patients with adrenal insufficiency of any cause were 1.28 (1.20-1.36, unadjusted) and 1.07 (1.01-1.14, adjusted). Increased cerebrovascular events in patients with secondary adrenal insufficiency accounted for most of the increased hazard (1.53 (1.34-1.74, adjusted)) and were associated with cranial irradiation therapy. Cardiovascular mortality data were available for 3547 patients and 34944 controls. The adjusted hazard ratio for ischaemic heart disease mortality was 1.86 (1.25-2.78) for primary adrenal insufficiency and 1.39 (1.02-1.89) for secondary. CONCLUSION: Co-morbidities largely accounted for the increased cardiovascular events but in secondary adrenal insufficiency, cerebrovascular events were independently increased and associated with irradiation treatment. However, the risk of cardiovascular mortality remained increased even following adjustment for co-morbidities in both primary and secondary adrenal insufficiency.
AU  - Ngaosuwan,K
AU  - Johnston,DG
AU  - Godsland,IF
AU  - Cox,J
AU  - Majeed,A
AU  - Quint,JK
AU  - Oliver,N
AU  - Robinson,S
DO  - clinem/dgab063
EP  - 1293
PY  - 2021///
SN  - 0021-972X
SP  - 1284
TI  - Cardiovascular disease in patients with primary and secondary adrenal insufficiency and the role of comorbidities
T2  - Journal of Clinical Endocrinology and Metabolism
UR  - http://dx.doi.org/10.1210/clinem/dgab063
UR  - https://www.ncbi.nlm.nih.gov/pubmed/33585930
UR  - http://hdl.handle.net/10044/1/88842
VL  - 106
ER  -
Download