Author + information
- Pallavi Gomadama,b,
- Waqas Qureshia,b,
- Amit Shaha,b,
- Barry Freedmana,b,
- Daniel W. Bowdena,b,
- Elsayed Solimana,b and
- Joseph Yeboaha,b
Background: Historically, both systolic and diastolic blood pressures have been targeted to reduce cardiovascular (CV) mortality in the general population. Intensive systolic blood pressure (SBP) control reduces CV outcomes in non-diabetics (SPRINT trial), but not in diabetics (ACCORD trial). We hypothesized that alternative measures of blood pressure may be better predictors of CV mortality in diabetics.
Methods: Using data from NHANES III and Diabetes Heart Study, we assessed the association between blood pressure indices [SBP, diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP)] and CV mortality among diabetics and non-diabetics. Cox proportional hazard analyses were used to assess the associations.
Results: Of 19089 subjects, 3121 (16.3%) had diabetes. Diabetics were older, more likely to be taking blood pressure medications, or had prior stroke or CHD compared with non-diabetics. After a mean (SD) of 16.2 (6.1) years of follow up, 17.9% of diabetics and 8.8% of non-diabetics died of CV disease. Diabetes was associated with an increased risk of CV death in univariate and full models [HR (95%CI): 3.09 (2.80-3.42) vs. 1.50 (1.25-1.82) respectively]. Adjusted associations between blood pressure indices and CV death among diabetics and non-diabetics are as shown in the table.
Conclusions: While blood pressure indices are independent predictors of CV death in non-diabetics, they are not independent predictors in diabetics in this large combined cohort.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Diabetes and Other Issues in Cardiovascular Prevention
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1277-045
- 2017 American College of Cardiology Foundation