Blood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study

Background Blood pressure (BP) targets in elderly patients with diabetes remain unclear. We evaluated the association between BP and cardiovascular disease in elderly patients with diabetes without cardiovascular disease or heart failure. Methods and Results We performed a retrospective cohort study...

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Autores principales:	Sangmo Hong, Jung Hwan Park, Kyungdo Han, Chang Beom Lee, Dong Sun Kim, Sung Hoon Yu
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	diastolic blood pressure hypertension myocardial infarction stroke systolic blood pressure Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/4761685b451f4eeda52b5443a1065785
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spelling	oai:doaj.org-article:4761685b451f4eeda52b5443a10657852021-11-16T10:22:43ZBlood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study10.1161/JAHA.121.0209992047-9980https://doaj.org/article/4761685b451f4eeda52b5443a10657852021-11-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.020999https://doaj.org/toc/2047-9980Background Blood pressure (BP) targets in elderly patients with diabetes remain unclear. We evaluated the association between BP and cardiovascular disease in elderly patients with diabetes without cardiovascular disease or heart failure. Methods and Results We performed a retrospective cohort study of 225 563 elderly (aged ≥65 years) patients with diabetes without cardiovascular disease or heart failure from 2009 to 2017 using the National Health Information Database. We divided the participants by systolic BP (SBP) and diastolic BP. Primary composite outcomes were stroke, myocardial infarction, heart failure, and all‐cause death analyzed by Cox proportional hazards regression analysis adjusted for baseline covariates. During a median follow‐up of 7.76 years, the incidence rate of primary composite outcomes was 26.62 per 1000 person‐years. In multivariable Cox proportional hazard modeling, the risk of the primary outcome had a U‐curved association with SBP/diastolic blood pressure with a nadir between 120 and 129 mm Hg/65 and 69 mm Hg, respectively. Hypertension medication was associated with lower risk of primary composite outcomes in SBP ≥140 mm Hg (P for interaction for SBP <0.001) and diastolic blood pressure ≥90 mm Hg (P for interaction for diastolic blood pressure=0.018). In participants aged ≥80 years, SBP ≥160 mm Hg was only a marginally higher risk for primary composite outcomes (hazard ratio=1.11; 95% CI, 0.98–1.24). Conclusions In this large sample of older Korean patients with diabetes, cardiovascular events were more common in people with resting SBP or diastolic BP ≥140 or 95 mm Hg, respectively, and also more common in people with resting SBP or diastolic BP <120 or 65 mm Hg, respectively.Sangmo HongJung Hwan ParkKyungdo HanChang Beom LeeDong Sun KimSung Hoon YuWileyarticlediastolic blood pressurehypertensionmyocardial infarctionstrokesystolic blood pressureDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 22 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	diastolic blood pressure hypertension myocardial infarction stroke systolic blood pressure Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	diastolic blood pressure hypertension myocardial infarction stroke systolic blood pressure Diseases of the circulatory (Cardiovascular) system RC666-701 Sangmo Hong Jung Hwan Park Kyungdo Han Chang Beom Lee Dong Sun Kim Sung Hoon Yu Blood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study
description	Background Blood pressure (BP) targets in elderly patients with diabetes remain unclear. We evaluated the association between BP and cardiovascular disease in elderly patients with diabetes without cardiovascular disease or heart failure. Methods and Results We performed a retrospective cohort study of 225 563 elderly (aged ≥65 years) patients with diabetes without cardiovascular disease or heart failure from 2009 to 2017 using the National Health Information Database. We divided the participants by systolic BP (SBP) and diastolic BP. Primary composite outcomes were stroke, myocardial infarction, heart failure, and all‐cause death analyzed by Cox proportional hazards regression analysis adjusted for baseline covariates. During a median follow‐up of 7.76 years, the incidence rate of primary composite outcomes was 26.62 per 1000 person‐years. In multivariable Cox proportional hazard modeling, the risk of the primary outcome had a U‐curved association with SBP/diastolic blood pressure with a nadir between 120 and 129 mm Hg/65 and 69 mm Hg, respectively. Hypertension medication was associated with lower risk of primary composite outcomes in SBP ≥140 mm Hg (P for interaction for SBP <0.001) and diastolic blood pressure ≥90 mm Hg (P for interaction for diastolic blood pressure=0.018). In participants aged ≥80 years, SBP ≥160 mm Hg was only a marginally higher risk for primary composite outcomes (hazard ratio=1.11; 95% CI, 0.98–1.24). Conclusions In this large sample of older Korean patients with diabetes, cardiovascular events were more common in people with resting SBP or diastolic BP ≥140 or 95 mm Hg, respectively, and also more common in people with resting SBP or diastolic BP <120 or 65 mm Hg, respectively.
format	article
author	Sangmo Hong Jung Hwan Park Kyungdo Han Chang Beom Lee Dong Sun Kim Sung Hoon Yu
author_facet	Sangmo Hong Jung Hwan Park Kyungdo Han Chang Beom Lee Dong Sun Kim Sung Hoon Yu
author_sort	Sangmo Hong
title	Blood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study
title_short	Blood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study
title_full	Blood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study
title_fullStr	Blood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study
title_full_unstemmed	Blood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study
title_sort	blood pressure and cardiovascular disease in older patients with diabetes: retrospective cohort study
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/4761685b451f4eeda52b5443a1065785
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_version_	1718426542722252800

Blood Pressure and Cardiovascular Disease in Older Patients With Diabetes: Retrospective Cohort Study

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