Maximum home BP predicts cardiovascular outcomes in T2D patients

In patients with type 2 diabetes (T2D), maximum home blood pressure (BP) may be used as a potential marker of subsequent cardiovascular events, suggests a retrospective cohort study.

“We previously showed that maximum home BP was significantly associated with development of diabetic nephropathy,” the researchers said. “In the same cohort of patients with diabetes as in the previous study, this study aimed to evaluate the prognostic BP values for the onset of first cardiovascular events.”

A total of 1,082 T2D patients (median age 65.0 years, 47.0 percent female), without a history of macrovascular complications, were included in the analysis.

The researchers performed BP measurements in triplicates every morning and evening for 14 consecutive days from the start of the study. They also evaluated the risk of the first major cardiovascular event, the primary endpoint, using a Cox hazards model.

During a mean follow-up of 7.0 years, 119 patients experienced a first major cardiovascular event (incidence rate, 15.7/1,000 person-years).

The adjusted hazard ratios (HRs) for cardiovascular events, adjusted by sex, duration of diabetes, body mass index, HbA1c, low-density lipoprotein cholesterol, smoking status, and use of antihypertensive medications were 1.12 (95 percent confidence interval [CI], 1.01‒1.24) for maximum morning systolic blood pressure (SBP) and 1.19 (95 percent CI, 1.07‒1.31) for maximum evening SBP.

Using the Youden’s index, the cutoff values of maximum BP for the events were 150 mm Hg in the morning (HR, 1.73, 95 percent CI, 1.07‒2.81) and 157 mm Hg in the evening (HR, 2.30, 95 percent CI, 1.46‒3.61).