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Article: Do we need a Patient-centered Target for Systolic Blood Pressure in Hypertensive Patients With Type 2 Diabetes Mellitus?

TitleDo we need a Patient-centered Target for Systolic Blood Pressure in Hypertensive Patients With Type 2 Diabetes Mellitus?
Authors
KeywordsBlood pressure
Cardiovascular diseases
Diabetes mellitus
Hypertension
Mortality
Issue Date2017
PublisherAmerican Heart Association, co-published with Lippincott Williams & Wilkins. The Journal's web site is located at http://hyper.ahajournals.org/
Citation
Hypertension, 2017, v. 70 n. 6, p. 1273-1282 How to Cite?
AbstractThe current trend on diabetes mellitus management advocates replacing the paradigm from a uniform to an individualized patient-centered systolic blood pressure (SBP), but there is no consensus on the achieved treatment goals of SBP level. The study aimed at evaluating the association between SBP and the risk of cardiovascular diseases (CVD) and all-cause mortality for diabetic patients to identify patient-centered treatment targets. A retrospective study was conducted on 95 086 Chinese adult primary care patients with type 2 diabetes mellitus and hypertension. Using the average of the annual SBP records (updated SBP) over a median follow-up of 5.9 years, the risks of overall CVD, all-cause mortality, and their composite associated with SBP were evaluated using Cox proportional hazards regression. Subgroup analysis was performed on the incidence of CVD by stratifying patient’s baseline characteristics. The SBP range for the lowest risk of CVD and all-cause mortality was 130 to 134 mm Hg among type 2 diabetes mellitus population. A J-shaped curvilinear relationship was identified between SBP and risk of CVD and all-cause mortality, irrespective of patients’ characteristics. The findings showed that all patients with SBP <125 mm Hg or ≥140 mm Hg had an increased risk of CVD and mortality. This large territory-wide study showed the level of achieved SBP of 125 to 139 mm Hg in pharmacological therapy, irrespective of patients’ characteristics, suggested that the SBP treatment goal of <140 mm Hg and individualized SBP target may not be necessary in diabetic management.
Persistent Identifierhttp://hdl.handle.net/10722/247505
ISSN
2017 Impact Factor: 6.823
2015 SCImago Journal Rankings: 3.702
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWan, EYF-
dc.contributor.authorYu, YTE-
dc.contributor.authorFung, SCC-
dc.contributor.authorChin, WY-
dc.contributor.authorFong, DYT-
dc.contributor.authorChan, AKC-
dc.contributor.authorLam, CLK-
dc.date.accessioned2017-10-18T08:28:19Z-
dc.date.available2017-10-18T08:28:19Z-
dc.date.issued2017-
dc.identifier.citationHypertension, 2017, v. 70 n. 6, p. 1273-1282-
dc.identifier.issn0194-911X-
dc.identifier.urihttp://hdl.handle.net/10722/247505-
dc.description.abstractThe current trend on diabetes mellitus management advocates replacing the paradigm from a uniform to an individualized patient-centered systolic blood pressure (SBP), but there is no consensus on the achieved treatment goals of SBP level. The study aimed at evaluating the association between SBP and the risk of cardiovascular diseases (CVD) and all-cause mortality for diabetic patients to identify patient-centered treatment targets. A retrospective study was conducted on 95 086 Chinese adult primary care patients with type 2 diabetes mellitus and hypertension. Using the average of the annual SBP records (updated SBP) over a median follow-up of 5.9 years, the risks of overall CVD, all-cause mortality, and their composite associated with SBP were evaluated using Cox proportional hazards regression. Subgroup analysis was performed on the incidence of CVD by stratifying patient’s baseline characteristics. The SBP range for the lowest risk of CVD and all-cause mortality was 130 to 134 mm Hg among type 2 diabetes mellitus population. A J-shaped curvilinear relationship was identified between SBP and risk of CVD and all-cause mortality, irrespective of patients’ characteristics. The findings showed that all patients with SBP <125 mm Hg or ≥140 mm Hg had an increased risk of CVD and mortality. This large territory-wide study showed the level of achieved SBP of 125 to 139 mm Hg in pharmacological therapy, irrespective of patients’ characteristics, suggested that the SBP treatment goal of <140 mm Hg and individualized SBP target may not be necessary in diabetic management.-
dc.languageeng-
dc.publisherAmerican Heart Association, co-published with Lippincott Williams & Wilkins. The Journal's web site is located at http://hyper.ahajournals.org/-
dc.relation.ispartofHypertension-
dc.rightsThis article is published in Hypertension by American Heart Association. The final published version is available online at http://dx.doi.org/10.1161/HYPERTENSIONAHA.117.10034-
dc.subjectBlood pressure-
dc.subjectCardiovascular diseases-
dc.subjectDiabetes mellitus-
dc.subjectHypertension-
dc.subjectMortality-
dc.titleDo we need a Patient-centered Target for Systolic Blood Pressure in Hypertensive Patients With Type 2 Diabetes Mellitus?-
dc.typeArticle-
dc.identifier.emailWan, EYF: yfwan@hku.hk-
dc.identifier.emailYu, YTE: ytyu@hku.hk-
dc.identifier.emailFung, SCC: cfsc@hku.hk-
dc.identifier.emailChin, WY: chinwy@hku.hk-
dc.identifier.emailFong, DYT: dytfong@hku.hk-
dc.identifier.emailChan, AKC: kcchanae@hku.hk-
dc.identifier.emailLam, CLK: clklam@hku.hk-
dc.identifier.authorityWan, EYF=rp02518-
dc.identifier.authorityYu, YTE=rp01693-
dc.identifier.authorityFung, SCC=rp01330-
dc.identifier.authorityChin, WY=rp00290-
dc.identifier.authorityFong, DYT=rp00253-
dc.identifier.authorityLam, CLK=rp00350-
dc.description.naturepostprint-
dc.identifier.doi10.1161/HYPERTENSIONAHA.117.10034-
dc.identifier.pmid29038204-
dc.identifier.scopuseid_2-s2.0-85037681124-
dc.identifier.hkuros281365-
dc.identifier.volume70-
dc.identifier.issue6-
dc.identifier.spage1273-
dc.identifier.epage1282-
dc.identifier.isiWOS:000414943000031-
dc.publisher.placeUnited States-

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