心血管疾病改变了糖尿病患者收缩压与预后之间的关系。

Cardiovascular disease modifies the relationship between systolic blood pressure and outcomes in people with diabetes.

作者信息

Cai Anping, Wang Jiabin, Feng Xiaoxuan, Parati Gianfranco, Wang Ji-Guang, Feng Yingqing, Nie Zhiqiang

机构信息

Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou 510080, China; Department of Epidemiology, Global Health Research Center, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Sothern Medical University, Guangzhou 510080, China.

出版信息

Diabetes Res Clin Pract. 2024 Dec;218:111909. doi: 10.1016/j.diabres.2024.111909. Epub 2024 Oct 30.

DOI:10.1016/j.diabres.2024.111909

PMID:39481649

Abstract

OBJECTIVE

We aimed to evaluate the influences of cardiovascular disease (CVD) on the relationship between baseline systolic blood pressure (SBP) and outcomes in community populations with diabetes.

METHODS

This is an observational study of 16,431 community adults with diabetes. The relationship between SBP with major adverse cardiovascular event (MACE) and all-cause death were evaluated using multivariable-adjusted Cox proportional hazard models and restricted cubic spline.

RESULTS

After a median follow-up of 3.4 (IQR 2.6, 4.3) years, 2145 (13.1 %) MACE and 1025 (6.2 %) all-cause death occurred. In participants free of CVD, in reference to SBP < 120 mmHg group, the risks for MACE increased as SBP category (120-129, 130-139, and ≥ 140 mmHg) advanced (P-trend < 0.001), and there was a linear relationship (P-nonlinear = 0.75). The risks for all-cause death were lower in SBP of 120-139 mmHg and 140-159 mmHg groups but higher in SBP ≥ 160 mmHg group, and there was a U-shaped relationship (P-nonlinear < 0.001). In participants with existing CVD the relationship between baseline SBP with MACE and all-cause death did not show any specific pattern.

CONCLUSION

Results of the current study suggest that the relationship between baseline SBP with MACE and all-cause death varied significantly by baseline CVD status.

摘要

目的

我们旨在评估心血管疾病（CVD）对糖尿病社区人群基线收缩压（SBP）与预后之间关系的影响。

方法

这是一项对16431名社区糖尿病成年人的观察性研究。使用多变量调整的Cox比例风险模型和受限立方样条评估SBP与主要不良心血管事件（MACE）及全因死亡之间的关系。

结果

在中位随访3.4（四分位间距2.6，4.3）年后，发生了2145例（13.1%）MACE和1025例（6.2%）全因死亡。在无CVD的参与者中，与SBP<120 mmHg组相比，随着SBP类别（120 - 129、130 - 139和≥140 mmHg）升高，MACE风险增加（P趋势<0.001），且存在线性关系（P非线性=0.75）。全因死亡风险在SBP为120 - 139 mmHg和140 - 159 mmHg组较低，但在SBP≥160 mmHg组较高，呈U形关系（P非线性<0.001）。在已有CVD的参与者中，基线SBP与MACE及全因死亡之间的关系未显示任何特定模式。