Association of blood pressure with incident diabetic microvascular complications among diabetic patients: Longitudinal findings from the UK Biobank.
| Autor: | Cong Li, Honghua Yu, Zhuoting Zhu, Xianwen Shang, Yu Huang, Sabanayagam, Charumathi, Xiaohong Yang, Lei Liu |
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| Předmět: |
DIABETES complications
HYPERTENSION GLYCOSYLATED hemoglobin CONFIDENCE intervals MULTIVARIATE analysis DISEASE incidence MANN Whitney U Test FISHER exact test RISK assessment T-test (Statistics) RESEARCH funding BLOOD pressure measurement DATA analysis software DIABETIC angiopathies PROPORTIONAL hazards models ALGORITHMS DOSE-response relationship in biochemistry LONGITUDINAL method DISEASE risk factors DISEASE complications |
| Zdroj: | Journal of Global Health; 2023, Vol. 13, p1-13, 13p |
| Abstrakt: | Background Evidence suggests a correlation of blood pressure (BP) level with presence of diabetic microvascular complications (DMCs), but the effect of BP on DMCs incidence is not well-established. We aimed to explore the associations between BP and DMCs (diabetic retinopathy, diabetic kidney disease, and diabetic neuropathy) risk in participants with diabetes. Methods This study included 23030 participants, free of any DMCs at baseline, from the UK Biobank. We applied multivariable-adjusted Cox regression models to estimate BP-DMCs association and constructed BP genetic risk scores (GRSs) to test their association with DMCs phenotypes. Differences in incidences of DMCs were also compared between the 2017 ACC/AHA and JNC 7 guidelines (traditional criteria) of hypertension. Results Compared to systolic blood pressure (SBP)<120 mm Hg, participants with SBP≥160 mm Hg had a hazard ratio (HR) of 1.50 (95% confidence interval (CI)=1.09, 2.06) for DMCs. Similarly, DMCs risk increased by 9% for every 10 mm Hg of higher SBP at baseline (95% CI=1.04, 1.13). The highest tercile SBP GRS was associated with 32% higher DMCs risk (95% CI=1.11, 1.56) compared to the lowest tercile. We found no significant differences in DMCs incidence between JNC 7 and 2017 ACC/AHA guidelines. Conclusions Genetic and epidemiological evidence suggests participants with higher SBP had an increased risk of DMCs, but hypertension defined by 2017 ACC/AHA guidelines may not impact DMCs incidence compared with JNC 7 criteria, contributing to the care and prevention of DMCs. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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