Blood pressure and risk of cardiovascular diseases in type 2 diabetes: further findings from the Swedish National Diabetes Register (NDR-BP II).
(2012) In Journal of Hypertension 30(10). p.2020-2030- Abstract
- OBJECTIVES:
Estimate risks of coronary heart disease (CHD), stroke and cardiovascular disease (CVD) with updated mean systolic (SBP) and diastolic (DBP) blood pressure in an observational study of patients with type 2 diabetes.
METHODS:
Thirty-five thousand and forty-one patients treated with antihypertensive drugs, and 18 512 untreated patients, aged 30-75 years, without previous heart failure, followed for 6 years until 2009.
RESULTS:
In treated patients, nonlinear splines for 6-year risk of fatal/nonfatal CHD, stroke and CVD by BP as a continuous variable showed a progressive increase with higher SBP from 140 mmHg and higher, and with DBP from 80 mmHg, with a J-shaped... (More) - OBJECTIVES:
Estimate risks of coronary heart disease (CHD), stroke and cardiovascular disease (CVD) with updated mean systolic (SBP) and diastolic (DBP) blood pressure in an observational study of patients with type 2 diabetes.
METHODS:
Thirty-five thousand and forty-one patients treated with antihypertensive drugs, and 18 512 untreated patients, aged 30-75 years, without previous heart failure, followed for 6 years until 2009.
RESULTS:
In treated patients, nonlinear splines for 6-year risk of fatal/nonfatal CHD, stroke and CVD by BP as a continuous variable showed a progressive increase with higher SBP from 140 mmHg and higher, and with DBP from 80 mmHg, with a J-shaped risk curve at lowest SBP levels, but not obviously at lowest DBP levels. Analysing intervals of SBP with 130-134 mmHg as reference at Cox regression, adjusted hazard ratios (HR) for fatal/nonfatal CHD, stroke and CVD with at least 140 mmHg were 1.22 [95% confidence interval (CI): 1.08-1.39], 1.43 (1.18-1.72), 1.26 (1.13-1.41), all P < 0.001. HR with 115-129 and 135-139 mmHg were nonsignificant, whereas increased with 100-114 mmHg, 1.96 (P < 0.001), 1.75 (P = 0.02), 2.08 (P < 0.001), respectively. With DBP 75-79 mmHg as reference, adjusted HR for fatal/nonfatal CHD, stroke and CVD with DBP 80-84 mmHg were 1.42 (1.26-1.59), 1.46 (1.24-1.72), 1.39 (1.26-1.53), all P < 0.001. Corresponding HR with DBP at least 85 mmHg were 1.70 (1.50-1.92), 2.35 (1.99-2.77), 1.87 (1.69-2.07), all P < 0.001. Corresponding HR with DBP 60-69 and 70-74 mmHg were nonsignificant. The picture was similar in 7059 patients with previous CVD and in untreated patients.
CONCLUSION:
BP around 130-135/75-79 mmHg showed lower risks of cardiovascular diseases in patients with type 2 diabetes. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/3047709
- author
- Cederholm, Jan ; Gudbjörnsdottir, Soffia ; Eliasson, Björn ; Zethelius, Björn ; Eeg-Olofsson, Katarina and Nilsson, Peter LU
- organization
- publishing date
- 2012
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Hypertension
- volume
- 30
- issue
- 10
- pages
- 2020 - 2030
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- wos:000308854500024
- pmid:22871895
- scopus:84866562620
- ISSN
- 1473-5598
- DOI
- 10.1097/HJH.0b013e3283577bdf
- language
- English
- LU publication?
- yes
- id
- 01d027b4-8b81-4190-a897-a3611d4f1218 (old id 3047709)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/22871895?dopt=Abstract
- date added to LUP
- 2016-04-04 09:12:27
- date last changed
- 2022-01-29 08:44:38
@article{01d027b4-8b81-4190-a897-a3611d4f1218,
abstract = {{OBJECTIVES:<br/><br>
Estimate risks of coronary heart disease (CHD), stroke and cardiovascular disease (CVD) with updated mean systolic (SBP) and diastolic (DBP) blood pressure in an observational study of patients with type 2 diabetes. <br/><br>
<br/><br>
METHODS:<br/><br>
Thirty-five thousand and forty-one patients treated with antihypertensive drugs, and 18 512 untreated patients, aged 30-75 years, without previous heart failure, followed for 6 years until 2009. <br/><br>
<br/><br>
RESULTS:<br/><br>
In treated patients, nonlinear splines for 6-year risk of fatal/nonfatal CHD, stroke and CVD by BP as a continuous variable showed a progressive increase with higher SBP from 140 mmHg and higher, and with DBP from 80 mmHg, with a J-shaped risk curve at lowest SBP levels, but not obviously at lowest DBP levels. Analysing intervals of SBP with 130-134 mmHg as reference at Cox regression, adjusted hazard ratios (HR) for fatal/nonfatal CHD, stroke and CVD with at least 140 mmHg were 1.22 [95% confidence interval (CI): 1.08-1.39], 1.43 (1.18-1.72), 1.26 (1.13-1.41), all P < 0.001. HR with 115-129 and 135-139 mmHg were nonsignificant, whereas increased with 100-114 mmHg, 1.96 (P < 0.001), 1.75 (P = 0.02), 2.08 (P < 0.001), respectively. With DBP 75-79 mmHg as reference, adjusted HR for fatal/nonfatal CHD, stroke and CVD with DBP 80-84 mmHg were 1.42 (1.26-1.59), 1.46 (1.24-1.72), 1.39 (1.26-1.53), all P < 0.001. Corresponding HR with DBP at least 85 mmHg were 1.70 (1.50-1.92), 2.35 (1.99-2.77), 1.87 (1.69-2.07), all P < 0.001. Corresponding HR with DBP 60-69 and 70-74 mmHg were nonsignificant. The picture was similar in 7059 patients with previous CVD and in untreated patients. <br/><br>
<br/><br>
CONCLUSION:<br/><br>
BP around 130-135/75-79 mmHg showed lower risks of cardiovascular diseases in patients with type 2 diabetes.}},
author = {{Cederholm, Jan and Gudbjörnsdottir, Soffia and Eliasson, Björn and Zethelius, Björn and Eeg-Olofsson, Katarina and Nilsson, Peter}},
issn = {{1473-5598}},
language = {{eng}},
number = {{10}},
pages = {{2020--2030}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Journal of Hypertension}},
title = {{Blood pressure and risk of cardiovascular diseases in type 2 diabetes: further findings from the Swedish National Diabetes Register (NDR-BP II).}},
url = {{http://dx.doi.org/10.1097/HJH.0b013e3283577bdf}},
doi = {{10.1097/HJH.0b013e3283577bdf}},
volume = {{30}},
year = {{2012}},
}