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Blood pressure level associated with lowest cardiovascular event in hypertensive diabetic patients

 Lee, Chan Joo  ;  Hwang, Jinseub  ;  Lee, Yong-ho  ;  Oh, Jaewon  ;  Lee, Sang-Hak  ;  Kang, Seok-Min  ;  Choi, Donghoon  ;  Kim, Hyeon Chang  ;  Park, Sungha 
 Journal of Hypertension, Vol.36(12) : 2434-2443, 2018 
Journal Title
 Journal of Hypertension 
Issue Date
BACKGROUND: The ACCORD BP trial failed to show the benefit of strict blood pressure (BP) control on cardiovascular events in diabetics with high cardiovascular risk. However, this result cannot be generalized to all diabetics. We investigated whether lower mean BP in diabetic people with hypertension is associated with better prognosis. METHODS: Participants from the Korea National Health Insurance Service Health Examinee Cohort who were diagnosed with diabetes and hypertension between 2003 and 2006 were included in the analysis (N = 7926). Mortality and cardiovascular events were compared among three groups according to mean SBP (<130, 130-<140, ≥140 mmHg) and mean DBP (<80, 80-<90, ≥ 90 mmHg) recorded during follow-up health examinations for up to 11 years. RESULTS: Significant reductions in the risk of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and end-stage renal disease were observed in patients with a mean SBP of 130 mmHg to less than 140 mmHg, as compared with patients with a mean SBP of at least 140 mmHg. The additional clinical benefit of a mean SBP of less than 130 mmHg was unclear. Lower risk of all-cause death, cardiovascular mortality, and nonfatal strokes was observed in patients with a mean DBP of 80 mmHg to less than 90 mmHg. A mean DBP of less than 80 mmHg was associated with further reduction in all-cause mortality, cardiovascular mortality, ischaemic stroke, and total stroke. CONCLUSION: A mean BP of less than 140/80 mmHg was associated with further reduction in the risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
6. Others (기타) > Dept. of Health Promotion (건강의학과) > 1. Journal Papers
Yonsei Authors
강석민(Kang, Seok Min) ORCID logo https://orcid.org/0000-0001-9856-9227
김현창(Kim, Hyeon Chang) ORCID logo https://orcid.org/0000-0001-7867-1240
박성하(Park, Sung Ha) ORCID logo https://orcid.org/0000-0001-5362-478X
오재원(Oh, Jae Won) ORCID logo https://orcid.org/0000-0002-4585-1488
이상학(Lee, Sang Hak) ORCID logo https://orcid.org/0000-0002-4535-3745
이용호(Lee, Yong Ho) ORCID logo https://orcid.org/0000-0002-6219-4942
이찬주(Lee, Chan Joo) ORCID logo https://orcid.org/0000-0002-8756-409X
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
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