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Decreased systolic blood pressure is associated with increased risk of all-cause mortality in patients with type 2 diabetes and renal impairment: A nationwide longitudinal observational study of 27,732 patients based on the Swedish National Diabetes Register
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Clinical diabetology and metabolism.
Skaraborg Hosp, Dept Nephrol, Skovde, Sweden..
Ctr Registers Vastra Gotaland, Gothenburg, Sweden..
Ctr Registers Vastra Gotaland, Gothenburg, Sweden..
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2017 (English)In: Diabetes & Vascular Disease Research, ISSN 1479-1641, E-ISSN 1752-8984, Vol. 14, no 3, 226-235 p.Article in journal (Refereed) Published
Abstract [en]

Background: Previous studies have shown a U-shaped relationship between systolic blood pressure and risk of all-cause of mortality in patients with type 2 diabetes and renal impairment.

Aims: To evaluate the associations between time-updated systolic blood pressure and time-updated change in systolic blood pressure during the follow-up period and risk of all-cause mortality in patients with type 2 diabetes and renal impairment.

Patients and methods: A total of 27,732 patients with type 2 diabetes and renal impairment in the Swedish National Diabetes Register were followed for 4.7years. Time-dependent Cox models were used to estimate risk of all-cause mortality. Time-updated mean systolic blood pressure is the average of the baseline and the reported post-baseline systolic blood pressures.

Results: A time-updated systolic blood pressure<130mmHg was associated with a higher risk of all-cause mortality in patients both with and without a history of chronic heart failure (hazard ratio: 1.25, 95% confidence interval: 1.13-1.40 and hazard ratio: 1.26, 1.17-1.36, respectively). A time-updated decrease in systolic blood pressure>10mmHg between the last two observations was associated with higher risk of all-cause mortality (-10 to -25mmHg; hazard ratio: 1.24, 95% confidence interval: 1.17-1.32).

Conclusion: Both low systolic blood pressure and a decrease in systolic blood pressure during the follow-up are associated with a higher risk of all-cause mortality in patients with type 2 diabetes and renal impairment.

Place, publisher, year, edition, pages
SAGE PUBLICATIONS LTD , 2017. Vol. 14, no 3, 226-235 p.
Keyword [en]
Type 2 diabetes, renal impairment, blood pressure, cardiovascular outcomes, all-cause mortality
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-323038DOI: 10.1177/1479164116683637ISI: 000400686700008PubMedID: 28467201OAI: oai:DiVA.org:uu-323038DiVA: diva2:1104713
Available from: 2017-06-01 Created: 2017-06-01 Last updated: 2017-06-01Bibliographically approved

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