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Blood pressure levels and cardiovascular risk according to age in patients with diabetes mellitus: a nationwide population-based cohort study

Authors
 Hack-Lyoung Kim  ;  Hyue Mee Kim  ;  Chang Hee Kwon  ;  Jeong-Hun Shin  ;  Mi-Hyang Jung  ;  Chan Joo Lee  ;  Dae-Hee Kim  ;  Woo-Hyeun Kim  ;  Si-Hyuck Kang  ;  Ju-Hee Lee  ;  In Jeong Cho  ;  Iksung Cho  ;  Jun Hyeok Lee  ;  Dae Ryong Kang  ;  Hae-Young Lee  ;  Wook-Jin Chung  ;  Sang-Hyun Ihm  ;  Kwang Il Kim  ;  Eun Joo Cho  ;  Il-Suk Sohn  ;  Hyeon-Chang Kim  ;  Jinho Shin  ;  Ju Han Kim  ;  Sung Kee Ryu  ;  Seok-Min Kang  ;  Wook Bum Pyun  ;  Myeong-Chan Cho  ;  Sungha Park  ;  Ki-Chul Sung 
Citation
 CARDIOVASCULAR DIABETOLOGY, Vol.19(1) : 181, 2020-10 
Journal Title
 CARDIOVASCULAR DIABETOLOGY 
Issue Date
2020-10
Keywords
Age ; Cardiovascular risk ; Diabetes mellitus ; Hypertension ; Target blood pressure
Abstract
Background: Little is known about age-specific target blood pressure (BP) in hypertensive patients with diabetes mellitus (DM). The aim of this study was to determine the BP level at the lowest cardiovascular risk of hypertensive patients with DM according to age. Methods: Using the Korean National Health Insurance Service database, we analyzed patients without cardiovascular disease diagnosed with both hypertension and DM from January 2002 to December 2011. Primary end-point was composite cardiovascular events including cardiovascular death, myocardial infarction and stroke. Results: Of 241,148 study patients, 35,396 had cardiovascular events during a median follow-up period of 10 years. At the age of < 70 years, the risk of cardiovascular events was lower in patients with BP < 120/70 mmHg than in those with BP 130-139/80-89 mmHg. At the age of ≥ 70, however, there were no significant differences in the risk of cardiovascular events between patients with BP 130-139/80-89 mmHg and BP < 120/70 mmHg. The risk of cardiovascular events was similar between patients with BP 130-139/80-89 mmHg and BP 120-129/70-79 mmHg, and it was significantly higher in those with BP ≥ 140/90 mmHg than in those with BP 130-139/80-89 mmHg at all ages. Conclusions: In a cohort of hypertensive patients who had DM but no history of cardiovascular disease, lower BP was associated with lower risk of cardiovascular events especially at the age of < 70. However, low BP < 130-139/80-89 mmHg was not associated with decreased cardiovascular risk, it may be better to keep the BP of 130-139/80-89 mmHg at the age of ≥ 70.
Files in This Item:
T202004484.pdf Download
DOI
10.1186/s12933-020-01156-8
Appears in Collections:
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
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
Cho, Ik Sung(조익성)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180249
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