Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Department of Endocrinology and Metabolism, Kyoto First Red Cross Hospital, Kyoto, Japan.
Diab Vasc Dis Res. 2023 Nov-Dec;20(6):14791641231221264. doi: 10.1177/14791641231221264.
AIMS/INTRODUCTION: Isolated high home systolic blood pressure (IHHSBP) is a risk for cardiovascular disease (CVD). However, no study has shown an association between IHHSBP and CVD in diabetes. We examined the association between IHHSBP and CVD in type 2 diabetes.
This retrospective cohort study included 1082 individuals with type 2 diabetes, aged 20 to 90 years, without a history of macrovascular complications. Home blood pressure (HBP) was measured three times every morning and evening for 14 days. Cox proportional hazards models were used to examine the relationship between IHHSBP and CVD incidence.
With the normal HBP group as the reference, the adjusted hazard ratio (HR) (95% confidence interval [CI]) for CVD was 1.58 (1.02-2.43) in the IHHSBP group. Correcting for antihypertensive medication use did not change HR. Based on sex, the adjusted HR (95% CI) for CVD was 1.25 (0.74-2.13) in males and 2.28 (1.01-5.15) in females.
In individuals with type 2 diabetes, those with IHHSBP had a higher HR for cardiovascular disease than those with normal HBP. But, Isolated high home diastolic blood pressure and high HBP were not. The association between IHHSBP and CVD was stronger in females than in males.
目的/引言:孤立性收缩期高血压(IHHSBP)是心血管疾病(CVD)的危险因素。然而,尚无研究表明 IHHSBP 与糖尿病患者的 CVD 之间存在关联。我们研究了 2 型糖尿病患者中 IHHSBP 与 CVD 之间的相关性。
本回顾性队列研究纳入了 1082 名年龄在 20 至 90 岁之间、无大血管并发症史的 2 型糖尿病患者。每天早晚各测量三次家庭血压(HBP),共 14 天。使用 Cox 比例风险模型来检查 IHHSBP 与 CVD 发生率之间的关系。
以正常 HBP 组为参照,IHHSBP 组的 CVD 调整后风险比(HR)(95%置信区间[CI])为 1.58(1.02-2.43)。校正降压药物使用后 HR 未发生变化。按性别分层后,男性的 CVD 调整后 HR(95%CI)为 1.25(0.74-2.13),女性为 2.28(1.01-5.15)。
在 2 型糖尿病患者中,IHHSBP 患者的心血管疾病风险高于正常 HBP 患者。但孤立性舒张期高血压和 HBP 升高患者并非如此。IHHSBP 与 CVD 的相关性在女性中强于男性。