Association of Blood Pressure With Cardio-Renal Events and Mortality in Type 2 DM: A National Health Insurance Databaseopen access
- Authors
- Kim, Bo-Yeon; Lee, Ji-In; Lee, Hye-Mi; Kim, So Hun; Mo, Eun Yeong; Son, Jang Won; Lee, Sihoon; Kim, Sungrae
- Issue Date
- Jul-2023
- Publisher
- ENDOCRINE SOC
- Keywords
- type 2 diabetes mellitus; cardiovascular disease; hypertension; blood pressure; Korea
- Citation
- JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, v.109, no.1, pp 227 - 236
- Pages
- 10
- Journal Title
- JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
- Volume
- 109
- Number
- 1
- Start Page
- 227
- End Page
- 236
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/25569
- DOI
- 10.1210/clinem/dgad404
- ISSN
- 0021-972X
1945-7197
- Abstract
- Context: The relationship of blood pressure (BP) with cardio-renal events and all-cause mortality in type 2 diabetes mellitus (T2DM) is still controversial. Objective: To investigate the optimal BP target in Korean individuals with T2DM. Methods: Using the Korean National Health Insurance System database, data of individuals with T2DM who underwent regular health checks from January 1, 2007, to December 31, 2007, were extracted (N = 1 800 073). Among them, a total of 326 593 individuals were included in the final study. The study population was divided into 7 groups according to their observed systolic blood pressure (SBP) (<110, 110-119, 120-129, 130-139, 140-149, 150-159, 160-169, and >= 170 mmHg) and diastolic blood pressure (DBP) (<65, 65-69, 70-74, 75-79, 80-84, 85-89, and >= 90 mmHg). Hazard ratios (HRs) of cardio-renal events and all-cause mortality according to BP categories were analyzed. Results: Compared with SBP of 120-129 mmHg and DBP of 75-79 mmHg, SBP of >= 130 mmHg and DBP of >= 80 mmHg were associated with an increase in HR of major cardiovascular adverse events (MACEs). SBP of 120-129 mmHg and DBP 75-79 mmHg were associated with the lowest HR of all-cause mortality. Both lower BP (SBP/DBP <120/70 mm) and higher BP (SBP/DBP >= 130/80 mmHg) were associated with an increased HR of all-cause mortality. Contrary to MACE, the lower the SBP, the lower the HR of renal events. Conclusion: In patients with T2DM, the optimal cutoff value of BP associated with a lower incidence of MACE and mortality may be 120-129 mmHg for SBP and 75-79 mmHg for DBP. However, lower SBP may be helpful for T2DM patients with a high risk of renal disease.
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