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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.

Artikel i vetenskaplig tidskrift
Författare Maria K Svensson
Henri Afghahi
Stefan Franzen
Staffan Björk
Soffia Gudbjörnsdottir
Ann-Marie Svensson
Björn Eliasson
Publicerad i Diabetes & vascular disease research
Volym 14
Nummer/häfte 3
Sidor 226-235
ISSN 1752-8984
Publiceringsår 2017
Publicerad vid
Sidor 226-235
Språk en
Länkar dx.doi.org/10.1177/1479164116683637
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Aged, Aged, 80 and over, Antihypertensive Agents, therapeutic use, Blood Pressure, drug effects, Cause of Death, Diabetes Mellitus, Type 2, diagnosis, mortality, physiopathology, Diabetic Nephropathies, diagnosis, mortality, physiopathology, Female, Glomerular Filtration Rate, Heart Failure, mortality, physiopathology, Humans, Hypertension, diagnosis, drug therapy, mortality, physiopathology, Kidney, physiopathology, Longitudinal Studies, Male, Prognosis, Proportional Hazards Models, Registries, Risk Assessment, Risk Factors, Sweden, epidemiology, Systole, Time Factors
Ämneskategorier Diabetologi

Sammanfattning

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.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.A total of 27,732 patients with type 2 diabetes and renal impairment in the Swedish National Diabetes Register were followed for 4.7 years. 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.A time-updated systolic blood pressure < 130 mmHg 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 > 10 mmHg between the last two observations was associated with higher risk of all-cause mortality (-10 to -25 mmHg; hazard ratio: 1.24, 95% confidence interval: 1.17-1.32).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.

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