Effects of different blood pressures and their long-term variability on the development of diabetic kidney disease in patients with type 2 diabetes mellitus

IF 1.5 4区医学 Q3 PERIPHERAL VASCULAR DISEASE

Clinical and Experimental Hypertension Pub Date : 2022-05-08 DOI:10.1080/10641963.2022.2071917

Weiyan Zhu, Lichen Xu, Xue Chen, Yau-Jiunn Lee, Zongjun Zhang, Qingqing Lou

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Abstract

ABSTRACT Aim To explore the relationship between long-term variabilities in different blood pressure variables and diabetic kidney disease (DKD) in patients with type 2 diabetes. Design A retrospective study. Methods This study included 3050 patients with type 2 diabetes whose metabolic parameters were regularly checked. Intrapersonal means and standard deviations (SDs) of all recorded systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) measurements were calculated. Subjects were divided into four groups: Q1 (SBP-Mean < 130, SBP-SD < 11.06); Q2 (SBP-Mean < 130, SBP-SD ≥ 11.06); Q3 (SBP-Mean ≥ 130, SBP-SD < 11.06); Q4 (SBP-Mean ≥ 130, SBP-SD ≥ 11.06). Similarly, based on whether the PP-Mean was higher or lower than 80 mmHg (average PP-Mean) and the PP-SD was higher or lower than 6.48 mmHg (average PP-SD), the involved patients were redivided into Q1’~ Q4’ groups. Results Adjusted for age, sex and diabetes duration, results revealed that the SBP-Mean, SBP-SD, PP-Mean and PP-SD were risk factors for DKD. Meanwhile, patients in the Q4 group had the highest DKD prevalence (HR = 1.976, p < .001), while Q1 group had the lowest. In addition, patients in the Q3 group (HR = 1.614, P < .001) had a higher risk of DKD than those in the Q2 group (HR = 1.408, P < .001). After re-stratification by PP-Mean and PP-SD, patients in the Q4’ group had the highest risk of DKD (HR = 1.370, p < .001), while those in the Q1’ group had the lowest risk. Patients in the Q3’ group (HR = 1.266, p < .001) had a higher risk of DKD than those in the Q2’ group (HR = 1.212, p < .001).

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不同血压及其长期变异性对2型糖尿病患者糖尿病肾病发展的影响

【摘要】目的探讨2型糖尿病患者不同血压变量的长期变异性与糖尿病肾病(DKD)的关系。设计回顾性研究。方法定期检查3050例2型糖尿病患者的代谢指标。计算所有记录的收缩压(SBP)、舒张压(DBP)、平均动脉压(MAP)和脉压(PP)的个人平均值和标准差(SDs)。受试者分为四组:Q1组(SBP-Mean < 130, SBP-SD < 11.06);Q2 (SBP-Mean < 130, SBP-SD≥11.06);Q3 (SBP-Mean≥130,SBP-SD < 11.06);Q4 (SBP-Mean≥130,SBP-SD≥11.06)。同样，根据PP-Mean高于或低于80 mmHg(平均PP-Mean)， PP-SD高于或低于6.48 mmHg(平均PP-SD)，将患者重新分为Q1’~ Q4’组。结果经年龄、性别和糖尿病病程调整后，结果显示SBP-Mean、SBP-SD、PP-Mean和PP-SD是DKD的危险因素。同时，Q4组患者DKD患病率最高(HR = 1.976, p < 0.001)， Q1组最低。此外，Q3组患者发生DKD的风险(HR = 1.614, P < 0.001)高于Q2组(HR = 1.408, P < 0.001)。经PP-Mean和PP-SD重新分层后，Q4’组患者DKD风险最高(HR = 1.370, p < 0.001)， Q1’组患者DKD风险最低。Q3组(HR = 1.266, p < 0.001)患者发生DKD的风险高于Q2组(HR = 1.212, p < 0.001)。

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来源期刊

Clinical and Experimental Hypertension 医学-外周血管病

CiteScore

3.90

自引率

0.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Clinical and Experimental Hypertension is a reputable journal that has converted to a full Open Access format starting from Volume 45 in 2023. While previous volumes are still accessible through a Pay to Read model, the journal now provides free and open access to its content. It serves as an international platform for the exchange of up-to-date scientific and clinical information concerning both human and animal hypertension. The journal publishes a wide range of articles, including full research papers, solicited and unsolicited reviews, and commentaries. Through these publications, the journal aims to enhance current understanding and support the timely detection, management, control, and prevention of hypertension-related conditions. One notable aspect of Clinical and Experimental Hypertension is its coverage of special issues that focus on the proceedings of symposia dedicated to hypertension research. This feature allows researchers and clinicians to delve deeper into the latest advancements in this field. The journal is abstracted and indexed in several renowned databases, including Pharmacoeconomics and Outcomes News (Online), Reactions Weekly (Online), CABI, EBSCOhost, Elsevier BV, International Atomic Energy Agency, and the National Library of Medicine, among others. These affiliations ensure that the journal's content receives broad visibility and facilitates its discoverability by professionals and researchers in related disciplines.