Among 4,399 patients in the intensive group , an increase in VVV of HbA1c was associated with an increased risk of vascular events ( P = 0.01 ) and with mortality ( P < 0.001 ) : highest versus lowest tenth hazard ratio ( 95 % CI ) 1.64 ( 1.05-2 .55 ) and 3.31 ( 1.57-6 .98 ) , respectively , after multivariable adjustment .