Systolic blood pressure and risk of cardiovascular disease in normotensive diabetic adults: a prospective cohort study.

IF 3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM
Endocrine Pub Date : 2024-09-01 Epub Date: 2024-05-16 DOI:10.1007/s12020-024-03803-6
Yingting Zuo, Shuohua Chen, Xue Tian, Shouling Wu, Anxin Wang
{"title":"Systolic blood pressure and risk of cardiovascular disease in normotensive diabetic adults: a prospective cohort study.","authors":"Yingting Zuo, Shuohua Chen, Xue Tian, Shouling Wu, Anxin Wang","doi":"10.1007/s12020-024-03803-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Currently, the special blood pressure (BP) target for normotensive diabetic patients has not been recommended. We investigated the optimal systolic blood pressure (SBP) for lower cardiovascular disease (CVD) risk in normotensive diabetic patients.</p><p><strong>Methods: </strong>In this 12-year follow-up study using the participants of the Kailuan Study, we mainly compared which SBP, 90-119 mmHg or 120-129 mmHg, had a lower risk of occurrence of CVD (stroke and myocardial infarction) in the 3072 normotensive diabetic participants and 21,532 normotensive and non-diabetic participants, respectively. The SBP was expressed as a mean time-weighted cumulative (MTWC) SBP, calculated from the multiple measurements of SBP during the follow-up. Multivariate competing risk regression analyses were used for the analysis.</p><p><strong>Results: </strong>We found that in normotensive diabetic participants, MTWC SBP of 120-129 mmHg was associated with a lower risk of CVD (HR = 0.69 [0.50-0.95]), myocardial infarction (HR = 0.48 [0.24-0.96]), and trending towards lower risk of stroke (HR = 0.80 [0.55-1.16]), compared to MTWC SBP of 90-119 mmHg. Sensitivity analyses confirmed the relationship between low SBP and increased CVD risk. Whereas, in the normotensive and non-diabetic participants, MTWC SBP of 90-119 mmHg vs 120-129 mmHg did not exhibit any difference in the risk of CVD occurrence (HR = 0.99 [0.83-1.18]).</p><p><strong>Conclusions: </strong>The higher level of SBP in normotensive diabetic patients is especially associated with a lower risk of CVD occurrence.</p>","PeriodicalId":49211,"journal":{"name":"Endocrine","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Endocrine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12020-024-03803-6","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/16 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Currently, the special blood pressure (BP) target for normotensive diabetic patients has not been recommended. We investigated the optimal systolic blood pressure (SBP) for lower cardiovascular disease (CVD) risk in normotensive diabetic patients.

Methods: In this 12-year follow-up study using the participants of the Kailuan Study, we mainly compared which SBP, 90-119 mmHg or 120-129 mmHg, had a lower risk of occurrence of CVD (stroke and myocardial infarction) in the 3072 normotensive diabetic participants and 21,532 normotensive and non-diabetic participants, respectively. The SBP was expressed as a mean time-weighted cumulative (MTWC) SBP, calculated from the multiple measurements of SBP during the follow-up. Multivariate competing risk regression analyses were used for the analysis.

Results: We found that in normotensive diabetic participants, MTWC SBP of 120-129 mmHg was associated with a lower risk of CVD (HR = 0.69 [0.50-0.95]), myocardial infarction (HR = 0.48 [0.24-0.96]), and trending towards lower risk of stroke (HR = 0.80 [0.55-1.16]), compared to MTWC SBP of 90-119 mmHg. Sensitivity analyses confirmed the relationship between low SBP and increased CVD risk. Whereas, in the normotensive and non-diabetic participants, MTWC SBP of 90-119 mmHg vs 120-129 mmHg did not exhibit any difference in the risk of CVD occurrence (HR = 0.99 [0.83-1.18]).

Conclusions: The higher level of SBP in normotensive diabetic patients is especially associated with a lower risk of CVD occurrence.

Abstract Image

收缩压与血压正常的糖尿病成人罹患心血管疾病的风险:一项前瞻性队列研究。
背景:目前,正常血压糖尿病患者的特殊血压(BP)目标尚未得到推荐。我们研究了降低血压正常的糖尿病患者心血管疾病(CVD)风险的最佳收缩压(SBP):在这项为期 12 年的随访研究中,我们以开滦研究的参与者为对象,主要比较了 90-119 mmHg 和 120-129 mmHg 哪种收缩压能降低 3072 名血压正常的糖尿病参与者以及 21,532 名血压正常和非糖尿病参与者的心血管疾病(中风和心肌梗死)发生风险。SBP以平均时间加权累积(MTWC)SBP表示,由随访期间多次测量的SBP计算得出。分析采用了多变量竞争风险回归分析:结果:我们发现,在血压正常的糖尿病患者中,与 MTWC SBP 为 90-119 mmHg 的患者相比,MTWC SBP 为 120-129 mmHg 的患者发生心血管疾病(HR = 0.69 [0.50-0.95])和心肌梗死(HR = 0.48 [0.24-0.96])的风险较低,发生脑卒中(HR = 0.80 [0.55-1.16])的风险呈下降趋势。敏感性分析证实了低 SBP 与心血管疾病风险增加之间的关系。而在正常血压和非糖尿病参与者中,MTWC SBP 为 90-119 mmHg 与 120-129 mmHg 的心血管疾病发生风险没有任何差异(HR = 0.99 [0.83-1.18]):结论:正常血压糖尿病患者的 SBP 水平越高,发生心血管疾病的风险越低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Endocrine
Endocrine ENDOCRINOLOGY & METABOLISM-
CiteScore
6.50
自引率
5.40%
发文量
295
审稿时长
1.5 months
期刊介绍: Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信