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Aggressive blood pressure control increases coronary heart disease risk among diabetic patients

Wenhui Zhao1, Peter T Katzmarzyk, Ronald Horswell

  • 1Corresponding author: Gang Hu, gang.hu@pbrc.edu.

Diabetes Care
|May 22, 2013
PubMed

Insights

Aggressively controlling blood pressure in diabetic patients may increase coronary heart disease (CHD) risk. A U-shaped association exists between blood pressure levels and CHD risk in both African American and white diabetic individuals.

Area of Science:

  • Cardiovascular Medicine
  • Diabetes Research
  • Epidemiology

Background:

  • Blood pressure control is crucial for reducing coronary heart disease (CHD) risk in diabetic patients.
  • The optimal blood pressure level for minimizing CHD risk in this population remains unclear.

Purpose of the Study:

  • To investigate the association between various blood pressure levels and the risk of developing CHD in diabetic patients.
  • To determine if the lowest blood pressure is associated with the lowest CHD risk among individuals with diabetes.

Main Methods:

  • A prospective cohort study involving 17,536 African Americans and 12,618 white diabetic patients from 2000-2009.
  • Cox proportional hazards regression models were utilized to analyze the relationship between baseline and follow-up blood pressure and incident CHD cases.

Main Results:

  • A U-shaped association was observed between blood pressure levels and CHD risk in both African American and white diabetic patients.
  • Lower blood pressure (<110/65 mmHg) and higher blood pressure (≥160/100 mmHg) were associated with increased CHD risk compared to the reference group (130-139/80-90 mmHg).
  • The association varied by age, with a U-shaped pattern in younger adults and an inverse association in older adults.

Conclusions:

  • The study suggests a U-shaped or inverse relationship between blood pressure and CHD risk in diabetic patients.
  • Aggressive blood pressure control (e.g., <120/70 mmHg) may be linked to a higher risk of CHD in both African American and white individuals with diabetes.
Abstract

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