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Systolic Blood Pressure and Cardiovascular Risk in Patients with Diabetes: A Prospective Cohort Study

Lookup NU author(s): Dr Dexter CanoyORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© 2023 Lippincott Williams and Wilkins. All rights reserved. Background: Whether the association between systolic blood pressure (SBP) and risk of cardiovascular disease is monotonic or whether there is a nadir of optimal blood pressure remains controversial. We investigated the association between SBP and cardiovascular events in patients with diabetes across the full spectrum of SBP. Methods: A cohort of 49 000 individuals with diabetes aged 50 to 90 years between 1990 and 2005 was identified from linked electronic health records in the United Kingdom. Associations between SBP and cardiovascular outcomes (ischemic heart disease, heart failure, stroke, and cardiovascular death) were analyzed using a deep learning approach. Results: Over a median follow-up of 7.3 years, 16 378 cardiovascular events were observed. The relationship between SBP and cardiovascular events followed a monotonic pattern, with the group with the lowest baseline SBP of <120 mm Hg exhibiting the lowest risk of cardiovascular events. In comparison to the reference group with the lowest SBP (<120 mm Hg), the adjusted risk ratio for cardiovascular disease was 1.03 (95% CI, 0.97-1.10) for SBP between 120 and 129 mm Hg, 1.05 (0.99-1.11) for SBP between 130 and 139 mm Hg, 1.08 (1.01-1.15) for SBP between 140 and 149 mm Hg, 1.12 (1.03-1.20) for SBP between 150 and 159 mm Hg, and 1.19 (1.09-1.28) for SBP ≥160 mm Hg. Conclusions: Using deep learning modeling, we found a monotonic relationship between SBP and risk of cardiovascular outcomes in patients with diabetes, without evidence of a J-shaped relationship.

Publication metadata

Author(s): Rao S, Li Y, Nazarzadeh M, Canoy D, Mamouei M, Hassaine A, Salimi-Khorshidi G, Rahimi K

Publication type: Article

Publication status: Published

Journal: Hypertension

Year: 2023

Volume: 80

Issue: 3

Pages: 598-607

Print publication date: 01/03/2023

Online publication date: 30/12/2022

Acceptance date: 08/12/2022

Date deposited: 01/03/2024

ISSN (print): 0194-911X

ISSN (electronic): 1524-4563

Publisher: Lippincott Williams and Wilkins

URL: https://doi.org/10.1161/HYPERTENSIONAHA.122.20489

DOI: 10.1161/HYPERTENSIONAHA.122.20489

PubMed id: 36583386

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