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Interaction between Mean Arterial Pressure and HbA1c in Prediction of Cardiovascular Disease Hospitalisation: A

Dahai Yu1, Zhanzheng Zhao2, David Simmons3

  • 1Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China; Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele ST5 5BG, UK.

Journal of Diabetes Research
|July 7, 2016
PubMed

Insights

Mean arterial pressure (MAP) is a key predictor of cardiovascular hospitalisation risk in type 2 diabetes. Optimal MAP for lowest risk is 93-101 mmHg, with higher risk seen at lower MAP and HbA1c levels.

Area of Science:

  • Cardiology
  • Endocrinology
  • Public Health

Background:

  • Type 2 diabetes significantly increases cardiovascular (CV) hospitalisation risk.
  • Understanding the interplay between blood pressure and glycemic control is crucial for mitigating CV events.

Purpose of the Study:

  • To investigate the relationship between mean arterial pressure (MAP), HbA1c, and the risk of cardiovascular hospitalisation in type 2 diabetes patients.
  • To identify specific MAP and HbA1c thresholds associated with varying CV hospitalisation risks.

Main Methods:

  • A population-based case-control study design was employed in Cambridgeshire, UK.
  • Included 588 type 2 diabetes patients with CV hospitalisation and 2920 matched controls.
  • Conditional logistic regression analyzed dose-response relationships between MAP, HbA1c, and CV hospitalisation risk.

Main Results:

  • A nonlinear relationship was observed between MAP and CV hospitalisation risk (P < 0.001).
  • The lowest CV hospitalisation risk was associated with a MAP of 97 mmHg (95% CI: 93-101 mmHg).
  • An interaction effect showed increased CV hospitalisation risk with both low MAP (<97 mmHg) and low HbA1c (<7% or 53 mmol/mol).

Conclusions:

  • Mean arterial pressure (MAP) is a significant predictor of cardiovascular hospitalisation in type 2 diabetes.
  • Maintaining MAP between 93-101 mmHg is associated with the lowest CV hospitalisation risk.
  • Individuals with type 2 diabetes exhibiting both low MAP and low HbA1c levels face particularly elevated CV hospitalisation risks.

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