Blood pressure level associated with lowest cardiovascular event in hypertensive diabetic patients

Chan Joo Lee, Jinseub Hwang, Yong Ho Lee, Jaewon Oh, Sang Hak Lee, Seok Min Kang, Donghoon Choi, Hyeon Chang Kim, Sungha Park

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The ACCORD BP trial failed to show the benefit of strict blood pressure (BP) control on cardiovascular events in diabetics with high cardiovascular risk. However, this result cannot be generalized to all diabetics. We investigated whether lower mean BP in diabetic people with hypertension is associated with better prognosis. Methods: Participants from the Korea National Health Insurance Service Health Examinee Cohort who were diagnosed with diabetes and hypertension between 2003 and 2006 were included in the analysis (N¼7926). Mortality and cardiovascular events were compared among three groups according to mean SBP (<130, 130-<140, 140mmHg) and mean DBP (<80, 80-<90, 90mmHg) recorded during follow-up health examinations for up to 11 years. Results: Significant reductions in the risk of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and end-stage renal disease were observed in patients with a mean SBP of 130mmHg to less than 140mmHg, as compared with patients with a mean SBP of at least 140mmHg. The additional clinical benefit of a mean SBP of less than 130mmHg was unclear. Lower risk of all-cause death, cardiovascular mortality, and nonfatal strokes was observed in patients with a mean DBP of 80mmHg to less than 90mmHg. A mean DBP of less than 80mmHg was associated with further reduction in all-cause mortality, cardiovascular mortality, ischaemic stroke, and total stroke. Conclusion: A mean BP of less than 140/80mmHg was associated with further reduction in the risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients.

Original languageEnglish
Pages (from-to)2434-2443
Number of pages10
JournalJournal of Hypertension
Volume36
Issue number12
DOIs
Publication statusPublished - 2018 Jan 1

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Blood Pressure
Mortality
Stroke
National Health Programs
Risk Reduction Behavior
Cause of Death
Hypertension
Health
Korea
Chronic Kidney Failure
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Blood pressure level associated with lowest cardiovascular event in hypertensive diabetic patients",
abstract = "Background: The ACCORD BP trial failed to show the benefit of strict blood pressure (BP) control on cardiovascular events in diabetics with high cardiovascular risk. However, this result cannot be generalized to all diabetics. We investigated whether lower mean BP in diabetic people with hypertension is associated with better prognosis. Methods: Participants from the Korea National Health Insurance Service Health Examinee Cohort who were diagnosed with diabetes and hypertension between 2003 and 2006 were included in the analysis (N¼7926). Mortality and cardiovascular events were compared among three groups according to mean SBP (<130, 130-<140, 140mmHg) and mean DBP (<80, 80-<90, 90mmHg) recorded during follow-up health examinations for up to 11 years. Results: Significant reductions in the risk of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and end-stage renal disease were observed in patients with a mean SBP of 130mmHg to less than 140mmHg, as compared with patients with a mean SBP of at least 140mmHg. The additional clinical benefit of a mean SBP of less than 130mmHg was unclear. Lower risk of all-cause death, cardiovascular mortality, and nonfatal strokes was observed in patients with a mean DBP of 80mmHg to less than 90mmHg. A mean DBP of less than 80mmHg was associated with further reduction in all-cause mortality, cardiovascular mortality, ischaemic stroke, and total stroke. Conclusion: A mean BP of less than 140/80mmHg was associated with further reduction in the risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients.",
author = "Lee, {Chan Joo} and Jinseub Hwang and Lee, {Yong Ho} and Jaewon Oh and Lee, {Sang Hak} and Kang, {Seok Min} and Donghoon Choi and Kim, {Hyeon Chang} and Sungha Park",
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Blood pressure level associated with lowest cardiovascular event in hypertensive diabetic patients. / Lee, Chan Joo; Hwang, Jinseub; Lee, Yong Ho; Oh, Jaewon; Lee, Sang Hak; Kang, Seok Min; Choi, Donghoon; Kim, Hyeon Chang; Park, Sungha.

In: Journal of Hypertension, Vol. 36, No. 12, 01.01.2018, p. 2434-2443.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Blood pressure level associated with lowest cardiovascular event in hypertensive diabetic patients

AU - Lee, Chan Joo

AU - Hwang, Jinseub

AU - Lee, Yong Ho

AU - Oh, Jaewon

AU - Lee, Sang Hak

AU - Kang, Seok Min

AU - Choi, Donghoon

AU - Kim, Hyeon Chang

AU - Park, Sungha

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The ACCORD BP trial failed to show the benefit of strict blood pressure (BP) control on cardiovascular events in diabetics with high cardiovascular risk. However, this result cannot be generalized to all diabetics. We investigated whether lower mean BP in diabetic people with hypertension is associated with better prognosis. Methods: Participants from the Korea National Health Insurance Service Health Examinee Cohort who were diagnosed with diabetes and hypertension between 2003 and 2006 were included in the analysis (N¼7926). Mortality and cardiovascular events were compared among three groups according to mean SBP (<130, 130-<140, 140mmHg) and mean DBP (<80, 80-<90, 90mmHg) recorded during follow-up health examinations for up to 11 years. Results: Significant reductions in the risk of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and end-stage renal disease were observed in patients with a mean SBP of 130mmHg to less than 140mmHg, as compared with patients with a mean SBP of at least 140mmHg. The additional clinical benefit of a mean SBP of less than 130mmHg was unclear. Lower risk of all-cause death, cardiovascular mortality, and nonfatal strokes was observed in patients with a mean DBP of 80mmHg to less than 90mmHg. A mean DBP of less than 80mmHg was associated with further reduction in all-cause mortality, cardiovascular mortality, ischaemic stroke, and total stroke. Conclusion: A mean BP of less than 140/80mmHg was associated with further reduction in the risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients.

AB - Background: The ACCORD BP trial failed to show the benefit of strict blood pressure (BP) control on cardiovascular events in diabetics with high cardiovascular risk. However, this result cannot be generalized to all diabetics. We investigated whether lower mean BP in diabetic people with hypertension is associated with better prognosis. Methods: Participants from the Korea National Health Insurance Service Health Examinee Cohort who were diagnosed with diabetes and hypertension between 2003 and 2006 were included in the analysis (N¼7926). Mortality and cardiovascular events were compared among three groups according to mean SBP (<130, 130-<140, 140mmHg) and mean DBP (<80, 80-<90, 90mmHg) recorded during follow-up health examinations for up to 11 years. Results: Significant reductions in the risk of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and end-stage renal disease were observed in patients with a mean SBP of 130mmHg to less than 140mmHg, as compared with patients with a mean SBP of at least 140mmHg. The additional clinical benefit of a mean SBP of less than 130mmHg was unclear. Lower risk of all-cause death, cardiovascular mortality, and nonfatal strokes was observed in patients with a mean DBP of 80mmHg to less than 90mmHg. A mean DBP of less than 80mmHg was associated with further reduction in all-cause mortality, cardiovascular mortality, ischaemic stroke, and total stroke. Conclusion: A mean BP of less than 140/80mmHg was associated with further reduction in the risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients.

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U2 - 10.1097/HJH.0000000000001842

DO - 10.1097/HJH.0000000000001842

M3 - Article

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VL - 36

SP - 2434

EP - 2443

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 12

ER -