Supplement materials:

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1 Supplement materials: Table S1: ICD-9 codes used to define prevalent comorbid conditions and incident conditions Comorbid condition ICD-9 code Hypertension Diabetes mellitus 250.x Myocardial infarction , 412 Angina 411, 413 CAD 414.0, 414.8, PCI 36.03, 36.04, 36.06, 36.07, CABG , CHF Peripheral arterial disease , 443, 443.x, 38.0, 38.1, 39.50, 39.22, 39.24, 39.25, 39.26, Cerebrovascular disease Chronic lung disease , , Dementia Rheumatologic disease 710.0, 710.1, 710.4, , , 725 Peptic ulcer disease , , , , Liver disease 571.x, 572.x, Hemiplegia or paraplegia 344.1,

2 Malignancy , , , HIV/AIDS 042, V08, Depression 296.x Abbreviations: CAD: coronary artery disease; PCI: percutaneous coronary intervention; CABG: coronary artery bypass grafting; CHF: congestive heart failure 2

3 Table S2: ICD9 codes used to define incident clinical events Incident event ICD9 code Acute myocardial infarction 410.x PCI 36.03, 36.04, 36.06, 36.07, CABG , Ischemic stroke 433.x, 434.x, 436.x Abbreviations: PCI: percutaneous coronary intervention; CABG: coronary artery bypass grafting 3

4 Table S3: Procedure (CPT) codes used to define coronary interventions Coronary intervention CPT code PCI CABG Abbreviations: PCI: percutaneous coronary intervention; CABG: coronary artery bypass grafting 4

5 Table S4A. Multivariable adjusted risk of all-cause mortality across categories of A1c and systolic blood pressure. HbA1c, % Systolic Blood Pressure, mmhg < >180 < ( )* 1.28 ( )* 1.15 ( )* 1.15 ( )* 1.23 ( )* 1.42 ( )* ( )* 1.15 ( )* ( )* 1.16 ( )* 1.20 ( )* ( )* 1.17 ( )* 1.05 ( )* 1.05 ( )* 1.17 ( )* 1.34 ( )* ( )* 1.31 ( )* 1.16 ( )* 1.21 ( )* 1.36 ( )* 1.52 ( )* ( )* 1.45 ( )* 1.28 ( )* 1.32 ( )* 1.54 ( )* 1.67 ( )* > ( )* 1.70 ( )* 1.56 ( )* 1.60 ( )* 1.74 ( )* 2.05 ( )* Data is presented as HR (hazard ratio) with 95% CI (confidence interval). * - P<0.001, - p<0.05. A1c of % and SBP mmhg group served as a reference group for all analyzes. 5

6 Table S4B. Multivariable adjusted risk of CVD across categories of A1c and systolic blood pressure. HbA1c, % Systolic Blood Pressure, mmhg < >180 < ( ) 0.91 ( ) 0.89 ( )* 1.00 ( ) 1.22 ( )* 1.42 ( )* ( ) 1.02 ( ) ( )* 1.14 ( ) 1.68 ( )* ( ) 1.18 ( )* 1.14 ( )* 1.26 ( )* 1.43 ( )* 1.84 ( )* ( ) 1.45 ( )* 1.41 ( )* 1.51 ( )* 1.66 ( )* 2.03 ( )* ( )* 1.45 ( )* 1.49 ( )* 1.69 ( )* 1.77 ( )* 1.81 ( )* > ( )* 1.75 ( )* 1.62 ( )* 1.87 ( )* 2.12 ( )* 2.49 ( )* Data is presented as HR (hazard ratio) with 95% CI (confidence interval). * - P<0.001, - p<0.05. A1c of % and SBP mmhg group served as a reference group for all analyzes. 6

7 Table S4C. Multivariable adjusted risk of stroke across categories of A1c and systolic blood pressure. HbA1c, % Systolic Blood Pressure, mmhg < >180 < ( ) 1.02 ( ) 1.03 ( ) 1.15 ( )* 1.36 ( )* 1.60 ( )* ( ) 0.98 ( ) ( )* 1.25 ( ) 1.59 ( )* ( ) 1.11 ( ) 1.15 ( )* 1.29 ( )* 1.59 ( )* 1.73 ( )* ( ) 1.34 ( )* 1.26 ( )* 1.52 ( )* 1.59 ( )* 1.88 ( )* ( ) 1.55 ( )* 1.50 ( )* 1.57 ( )* 2.05 ( )* 2.64 ( )* > ( )* 1.65 ( )* 1.69 ( )* 2.18 ( )* 2.49 ( )* 2.99 ( )* Data is presented as HR (hazard ratio) with 95% CI (confidence interval). * - P<0.001, - p<0.05. A1c of % and SBP mmhg group served as a reference group for all analyzes. 7

8 Table S4D. Multivariable adjusted risk of incident chronic kidney disease across categories of A1c and systolic blood pressure. HbA1c, % Systolic Blood Pressure, mmhg < >180 < ( ) 0.85 ( ) 0.88 ( ) 1.07 ( )* 1.25 ( )* 1.46 ( )* ( ) 0.92 ( ) ( )* 1.30 ( ) 1.54 ( )* ( ) 1.02 ( ) 1.11 ( )* 1.28 ( )* 1.60 ( )* 1.85 ( )* ( ) 1.08 ( ) 1.16 ( )* 1.47 ( )* 1.76 ( )* 1.94 ( )* ( )* 1.21 ( )* 1.26 ( )* 1.54 ( )* 1.94 ( )* 2.02 ( )* > ( )* 1.50 ( )* 1.46 ( )* 1.72 ( )* 2.05 ( )* 2.70 ( )* Data is presented as HR (hazard ratio) with 95% CI (confidence interval). * - P<0.001, - p<0.05. A1c of % and SBP mmhg group served as a reference group for all analyzes. 8

9 Figure Legends Supplementary Figure 1: Hazard ratios of the association of blood pressure and A1c categories and the risk of mortality based on age (Panel A) or ethnicity (Panel B). The associations of the categories with mortality risk were estimated from Cox proportional hazards models. Risk estimates were adjusted for the following factors at baseline: age, gender, race/ethnicity, baseline egfr, various socio-economic parameters, service connection, adherence to medical interventions, comorbidities, body mass index and statin treatment. The adjusted hazard ratios are compared to the reference category of systolic blood pressure of mmHg and A1c of % taken as 1.0. Supplementary Figure 2: Hazard ratios of the association of blood pressure and A1c categories on the risk of cardiovascular disease based on age (Panel A) and ethnicity (Panel B). The associations of the categories with risk of incident cardiovascular disease were estimated from Cox proportional hazards models. Risk estimates were adjusted for the following factors at baseline: age, gender, race/ethnicity, baseline egfr, various socio-economic parameters, service connection, adherence to medical interventions, comorbidities, body mass index and statin treatment. The adjusted hazard ratios are compared to the reference category of systolic blood pressure of mmHg and A1c of % taken as 1.0. Supplementary Figure 3: Hazard ratios of the association of blood pressure and A1c categories on the risk of stroke based on age (Panel A) and ethnicity (Panel B). The associations of the categories with risk of incident stroke were estimated from Cox proportional hazards models. Risk estimates were adjusted for the following factors at baseline: age, gender, race/ethnicity, baseline egfr, various socio-economic parameters, service connection, adherence to medical interventions, comorbidities, body mass index and statin treatment. The adjusted hazard ratios are 9

10 compared to the reference category of systolic blood pressure of mmHg and A1c of % taken as 1.0. Supplementary Figure 4: Hazard ratios of the associations of blood pressure and A1c categories on the risk of chronic kidney disease based on age (Panel A) and ethnicity (Panel B). The effects of the categories on the risk of incident chronic kidney disease were estimated from Cox proportional hazards models. Risk estimates were adjusted for the following factors at baseline: age, gender, race/ethnicity, baseline egfr, various socio-economic parameters, service connection, adherence to medical interventions, comorbidities, body mass index and statin treatment. The adjusted hazard ratios are compared to the reference category of systolic blood pressure of mmHg and A1c of % taken as

11 Supplementary Figure 1 Panel A: 11

12 Supplementary Figure 1 Panel B: 12

13 Supplementary Figure 2 Panel A: CHD Supplementary Figure 2 Panel B: 13

14 CHD Supplementary Figure 3 Panel A: 14

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16 Supplementary Figure 3 Panel B: 16

17 Supplementary Figure 4 Panel A: 17

18 Supplementary Figure 4 Panel B: 18

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