Complex Relationship Between Blood Pressure and Mortality in Type 2 Diabetic Patients
- 1 February 2006
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Hypertension
- Vol. 47 (2), 168-173
- https://doi.org/10.1161/01.hyp.0000199667.30253.b7
Abstract
The presence of hypertension aggravates the high cardiovascular risk in type 2 diabetic patients. Pulse pressure is a marker of arterial stiffness and constitutes a risk factor for cardiovascular mortality. This study examines the relationship between different blood pressure indices and mortality in a cohort of type 2 diabetic patients. A total of 1294 type 2 diabetic patients with a median age of 69.1 years participated in the Botnia Study from 1990 to 1997. In 2004, after a median follow-up of 9.5 years, data on mortality was collected from the national population registry and hospital records. Systolic and diastolic blood pressure correlated negatively with mortality after adjustment for other risk factors. The association between low systolic and diastolic blood pressure and mortality was pronounced in patients with previous cardiovascular disease. A U-shaped association between pulse pressure and mortality was observed in elderly patients. These observations could be linked to arterial stiffness and heart failure. Low blood pressure in high-risk patients is likely to be a marker of poor health rather than the cause of mortality. The results suggest that the role of blood pressure as a risk marker in elderly type 2 diabetic patients with cardiovascular disease needs to be reevaluated.Keywords
This publication has 23 references indexed in Scilit:
- Altered Age-Related Blood Pressure Pattern in Type 1 DiabetesCirculation, 2004
- Effects of Blood Pressure Level on Progression of Diabetic NephropathyResults From the RENAAL StudyArchives of Internal Medicine, 2003
- Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38BMJ, 1998
- Mortality from Coronary Heart Disease in Subjects with Type 2 Diabetes and in Nondiabetic Subjects with and without Prior Myocardial InfarctionThe New England Journal of Medicine, 1998
- Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trialThe Lancet, 1998
- Low blood pressure and five-year mortality in a Stockholm cohort of the very old: possible confounding by cognitive impairment and other factors.American Journal of Public Health, 1997
- Characterization of the MODY3 phenotype. Early-onset diabetes caused by an insulin secretion defect.JCI Insight, 1997
- Diabetes mellitus and echocardiographic left ventricular function in free-living elderly men and women: The Cardiovascular Health StudyAmerican Heart Journal, 1997
- Metabolic Consequences of a Family History of NIDDM (The Botnia Study): Evidence for Sex-Specific Parental EffectsDiabetes, 1996
- Microalbuminuria: A Major Risk Factor in Non‐insulin‐dependent Diabetes. A 10‐year Follow‐up Study of 503 PatientsDiabetic Medicine, 1988