Blood Pressure Variables and Cardiovascular Risk New Findings From ADVANCE

Kengne, Andre-Pascal, Czernichow, Sebastien, Huxley, Rachel, Grobbee, Diederick, Woodward, Mark, Neal, Bruce, Zoungas, Sophia, Cooper, Mark, Glasziou, Paul, Hamet, Pavel, Harrap, Stephen B., Mancia, Giuseppe, Poulter, Neil, Williams, Bryan and Chalmers, John (2009) Blood Pressure Variables and Cardiovascular Risk New Findings From ADVANCE. Hypertension, 54 2: 399-404. doi:10.1161/HYPERTENSIONAHA.109.133041


Author Kengne, Andre-Pascal
Czernichow, Sebastien
Huxley, Rachel
Grobbee, Diederick
Woodward, Mark
Neal, Bruce
Zoungas, Sophia
Cooper, Mark
Glasziou, Paul
Hamet, Pavel
Harrap, Stephen B.
Mancia, Giuseppe
Poulter, Neil
Williams, Bryan
Chalmers, John
Title Blood Pressure Variables and Cardiovascular Risk New Findings From ADVANCE
Journal name Hypertension   Check publisher's open access policy
ISSN 0194-911X
1524-4563
Publication date 2009-08
Year available 2009
Sub-type Article (original research)
DOI 10.1161/HYPERTENSIONAHA.109.133041
Volume 54
Issue 2
Start page 399
End page 404
Total pages 6
Place of publication Philadelphia, PA United States
Publisher Lippincott Williams and Wilkins
Collection year 2010
Language eng
Formatted abstract
The relative importance of various blood pressure indices on cardiovascular risk in people with type 2 diabetes mellitus has not been established. This study compares the strengths of the associations between different baseline blood pressure variables (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure) and the 4.3-year risk of major cardiovascular events in the Action in Diabetes and Vascular Disease: Preterax and Diamicron-Modified Release Controlled Evaluation Study. Mean (SD) age for the 11 140 participants was 65.8 years (6.4 years). During follow-up, 1000 major cardiovascular events, 559 major coronary events, and 468 cardiovascular deaths were recorded. After adjustment for age, sex, and treatment allocation, the hazard ratios (95% CIs) associated with 1 increment in SD for the risk of major cardiovascular events were 1.17 (1.10 to 1.24) for SBP; 1.20 (1.13 to 1.28) for PP; 1.12 (1.05 to 1.19) for mean arterial pressure; and 1.04 (0.98 to 1.11) for DBP. The areas under the receiver operating characteristic curve were slightly higher for SBP and PP compared with mean arterial pressure and DBP for major cardiovascular and coronary events. Using achieved instead of baseline blood pressure values marginally improved the effect estimates for SBP, DBP, and mean arterial pressure, with no significant differences in the areas under the receiver operating characteristic curve between models with SBP and those with PP. In conclusion, SBP and PP are the 2 best and DBP is the least effective determinant of the risk of major cardiovascular outcomes in the relatively old patients with type 2 diabetes mellitus participating in the Action in Diabetes and Vascular Disease: Preterax and Diamicron-Modified Release Controlled Evaluation Study. However, SBP may be the simplest and most useful predictor across a wider range of age groups and populations.
Keyword Blood pressure variables
Type 2 diabetes mellitus
Cardiovascular disease
Risk prediction
Discrimination capability
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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