Home BP predicts future cardiovascular events in type 2 diabetes

Home blood pressure (BP) may predict the development of future cardiovascular events in patients with type 2 diabetes (T2D), a recent study has found.

The study included 1,081 T2D patients (median age, 66.0 years; 44.5 percent women) from whom morning and evening BP measurements were collected in triplicate for 14 consecutive days. None of the patients had a history of macrovascular complications. The study’s primary outcome was the development of first major cardiovascular event.

Over a median follow-up of 7.0 years, 119 incident cardiovascular events were recorded. Most were cases of angina pectoris (n=42) or nonfatal strokes (n=31), though five deaths and two heart failures also occurred.

Unadjusted Cox proportional hazards analyses found that morning, evening, and clinical systolic BP (SBP) were significantly associated with incident cardiovascular events in diabetes, with hazard ratios (HRs) ranging from 1.11 to 1.21.

Multivariate adjustments, however, showed that only home morning SBP was independently and significantly correlated with cardiovascular events (HR, 1.14, 95 percent confidence interval [CI], 1.01–1.28). Of note, neither clinical SBP (HR, 1.06, 95 percent CI, 0.95–1.20) nor diastolic BP (HR, 0.91, 95 percent CI, 0.75–1.11) were indicative of cardiovascular event risk.

“[T]o the best of our knowledge, this retrospective cohort study of patients with T2D revealed, for the first time, the prognostic values of morning and evening BP for cardiovascular events,” the researchers said.

“The results may contribute to the development of guidelines and be valuable to clinicians involved in the management of patients with diabetes,” they added. “Home BP would be a better tool to assess cardiovascular risk associated with BP levels.”