Second home blood pressure measurements per occasion predict incident cardiovascular events in type 2 diabetes: KAMOGAWA-HBP study.

IF 4.3 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Hypertension Research Pub Date : 2024-12-13 DOI:10.1038/s41440-024-02049-z

Madoka Sumi, Emi Ushigome, Nobuko Kitagawa, Noriyuki Kitagawa, Toru Tanaka, Goji Hasegawa, Masayoshi Ohnishi, Sei Tsunoda, Naoko Nakanishi, Hiroshi Okada, Masahide Hamaguchi, Michiaki Fukui

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Abstract

Home blood pressure (HBP) monitoring is a better prognostic predictor than clinical BP monitoring. However, the suggested number of HBP measurements in each occasion varies across guidelines. The study aimed to identify which HBP measurements in each occasion are more closely associated with new cardiovascular events in patients with type 2 diabetes. This retrospective cohort study included 1082 patients with type 2 diabetes without a history of macrovascular complications. HBP was measured three times each morning and evening for 14 days, and the average value over the 14 days was calculated. During a median follow-up of 7.0 years, 117 patients (11.1%) had cardiovascular events. The Cox proportional hazards model was used to examine the association between the average morning home systolic BP (MHSBP) for the 1st, 2nd, and 3rd measurements and cardiovascular events. The adjusted hazard ratios (HR) (95% confidence interval) for the onset of cardiovascular events in the 2nd and 3rd mean MHSBP were 1.129 (1.008-1.265) and 1.135 (1.010-1.275), respectively. The area under the receiver-operating characteristic curve (AUC) for the 2nd, 1st/2nd, 2nd/3rd, and 1st/2nd/3rd mean MHSBP was significantly greater than that of the 1st mean MHSBP (p = 0.040, p = 0.014, p = 0.020, and p = 0.021, respectively). No significant difference was observed between the AUC of the 2nd/3rd and 1st/2nd/3rd mean MHSBP and that of the 1st/2nd mean MHSBP. We recommend that HBP measurements be taken just twice per occasion to predict cardiovascular events in patients with type 2 diabetes.

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第二次家庭血压测量可预测 2 型糖尿病患者的心血管事件：KAMOGAWA-HBP 研究。

与临床血压监测相比，家庭血压 (HBP) 监测能更好地预测预后。然而，不同指南建议的每次 HBP 测量次数各不相同。本研究旨在确定每次测量的 HBP 与 2 型糖尿病患者新发心血管事件的关系。这项回顾性队列研究纳入了1082名没有大血管并发症病史的2型糖尿病患者。在 14 天内每天早晚各测量三次 HBP，并计算出 14 天的平均值。在中位 7.0 年的随访期间，117 名患者（11.1%）发生了心血管事件。研究人员使用 Cox 比例危险模型来检验第 1、2 和 3 次测量的清晨家庭收缩压 (MHSBP) 平均值与心血管事件之间的关系。第 2 次和第 3 次平均 MHSBP 与心血管事件发生的调整后危险比（HR）（95% 置信区间）分别为 1.129（1.008-1.265）和 1.135（1.010-1.275）。第 2 次、第 1 次/第 2 次、第 2 次/第 3 次和第 1 次/第 2 次/第 3 次平均 MHSBP 的接收器工作特征曲线下面积 (AUC) 明显大于第 1 次平均 MHSBP（分别为 p = 0.040、p = 0.014、p = 0.020 和 p = 0.021）。第 2 次/第 3 次和第 1 次/第 2 次/第 3 次平均 MHSBP 的 AUC 与第 1 次/第 2 次平均 MHSBP 的 AUC 之间无明显差异。我们建议在预测 2 型糖尿病患者的心血管事件时，每次只需测量两次 HBP。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hypertension Research 医学-外周血管病

CiteScore

7.40

自引率

16.70%

发文量

249

审稿时长

3-8 weeks

期刊介绍： Hypertension Research is the official publication of the Japanese Society of Hypertension. The journal publishes papers reporting original clinical and experimental research that contribute to the advancement of knowledge in the field of hypertension and related cardiovascular diseases. The journal publishes Review Articles, Articles, Correspondence and Comments.