Blood pressure trajectories before death in patients with type 2 diabetes

Paul, Sanjoy, Klein, Kerenaftali, Thomas, Gijo and Khunti, Kamlesh (2012). Blood pressure trajectories before death in patients with type 2 diabetes. In: American Diabetes Association: 72nd Scientific Sessions, Philadelphia, PA, United States, (). 8 - 12 June 2012.

Author Paul, Sanjoy
Klein, Kerenaftali
Thomas, Gijo
Khunti, Kamlesh
Title of paper Blood pressure trajectories before death in patients with type 2 diabetes
Conference name American Diabetes Association: 72nd Scientific Sessions
Conference location Philadelphia, PA, United States
Conference dates 8 - 12 June 2012
Place of Publication Alexandria, VA, United States
Publisher American Diabetes Association
Publication Year 2012
Sub-type Poster
Language eng
Abstract/Summary The aim of this study is to examine the trajectory of blood pressure (BP) over two yrs before death or censoring and its association with mortality in patients (pts) with T2DM. A cohort of 19966 pts with minimum 3 yrs of diabetes duration (DD) was selected from the UK General Practice Research Database (1990-2008), who had four consecutive 6-monthly BP measures over 2 yrs immediately before death or censoring. In the cohort, 46% were female, mean (SD) age of 68 (11) years and 14% had at least one cardiovascular event (CVE) before diagnosis of diabetes. During 6.5 years of median duration of follow-up, 7% pts died, of whom 83% were aged ≥ 68 yrs, 53% and 20% pts had CVE respectively in dead and alive groups. During 2 yrs of follow-up, pts’ systolic and diastolic BP trajectories were significantly higher by 5 and 2 mmHg respectively in those who died, compared to those who were alive (Fig 1). These estimates were adjusted for the effects of age, DD, sex, CVE, glucose-lowering and anti-hypertensive medication usages, baseline weight and HbA1c. Compared to pts with systolic BP level 125 - 130 mmHg, pts with BP < 110 and > 140 mmHg had significantly higher mortality risk by 240% (adjusted odds ratio : 2.4, 95% CI: 1.9, 3.1) and 210% (adjusted odds ratio: 2.1, 95% CI: 1.8, 2.5) respectively. Mortality risk was not higher in patients with BP within 130 - 140 mmHg (Fig 1). The population level analyses of BP trajectories leading up to death are revealing, and provide clear message in terms of the requirement for intensive BP control and related management policies at primary care level. Our findings also establish the J-shaped relationship between systolic BP and mortality.
Q-Index Code EX
Q-Index Status Provisional Code
Institutional Status Unknown
Additional Notes Abstract Number: 433-P

Document type: Conference Paper
Collection: School of Public Health Publications
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Created: Thu, 13 Sep 2012, 15:52:51 EST by Sanjoy Paul on behalf of School of Public Health