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Blood pressure and risk of cardiovascular diseases in type 2 diabetes: further findings from the Swedish National Diabetes Register (NDR-BP II).

Cederholm, Jan; Gudbjörnsdottir, Soffia; Eliasson, Björn; Zethelius, Björn; Eeg-Olofsson, Katarina and Nilsson, Peter LU (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)
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author
organization
publishing date
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
2012-09-04 21:42:54
date last changed
2017-01-01 07:44:33
@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 &lt; 0.001. HR with 115-129 and 135-139 mmHg were nonsignificant, whereas increased with 100-114 mmHg, 1.96 (P &lt; 0.001), 1.75 (P = 0.02), 2.08 (P &lt; 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 &lt; 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 &lt; 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},
  volume       = {30},
  year         = {2012},
}