Zoppini Giacomo, Verlato Giuseppe, Zamboni Cristina, Venturi Cristina, Gennaro Nicola, Biasi Valeria, Bonora Enzo, Muggeo Michele
Division of Endocrinology and Metabolic Diseases, University of Verona, Verona, Italy.
Cerebrovasc Dis. 2007;23(1):20-6. doi: 10.1159/000095754. Epub 2006 Sep 12.
BACKGROUND/OBJECTIVE: Previous studies conducted both in the general and diabetic population have shown that pulse pressure (PP) can predict mortality from cardiovascular diseases. The aim of the present study was to investigate the relationship between PP and specific cardiovascular mortality, i.e. from cerebrovascular and ischemic heart diseases, in a well-characterized cohort of type 2 diabetic patients.
A cohort of 1,128 known type 2 diabetic patients 56 to 74 years of age with at least 2 blood pressure measurements for each year between 1984-1986 was followed-up for ten years to assess specific causes of death. The analyses were carried out by using the mean and the coefficient of variation (CV) of PP.
By the end of the 10-year follow-up period, 375 patients (178 male, 197 female) had died (33%). The mean PP resulted as an independent predictor of all causes and cardiovascular mortality. Remarkably, the mean PP, but not the CV of PP, was highly predictive of mortality from cerebrovascular diseases. The risk of cerebrovascular mortality rose by 86% with a 10 mm Hg increase in mean PP. PP turned out to be the most important predictor of cerebrovascular mortality among various pressure indexes (mean, systolic and diastolic pressure).
The mean pulse pressure, but not the coefficient of variation is a strong predictor of cardiovascular mortality, mainly from cerebrovascular diseases, in type 2 diabetic patients.
背景/目的：既往在普通人群和糖尿病患者中开展的研究均表明，脉压（PP）可预测心血管疾病死亡率。本研究旨在调查在一组特征明确的2型糖尿病患者中，PP与特定心血管疾病死亡率（即脑血管疾病和缺血性心脏病死亡率）之间的关系。
对1128例年龄在56至74岁之间的已知2型糖尿病患者进行队列研究，这些患者在1984年至1986年期间每年至少测量2次血压，并随访10年以评估具体死因。分析采用PP的均值和变异系数（CV）。
在10年随访期结束时，375例患者（178例男性，197例女性）死亡（33%）。PP均值是所有原因和心血管疾病死亡率的独立预测因素。值得注意的是，PP均值而非PP的CV对脑血管疾病死亡率具有高度预测性。平均PP每升高10 mmHg，脑血管疾病死亡风险增加86%。在各种血压指标（平均压、收缩压和舒张压）中，PP是脑血管疾病死亡率最重要的预测因素。
在2型糖尿病患者中，平均脉压而非变异系数是心血管疾病死亡率（主要是脑血管疾病死亡率）的有力预测因素。
