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Blood Pressure Variables and Cardiovascular Risk: New Findings From ADVANCE

The relative importance of various blood pressure indices on cardiovascular risk in people with type 2 diabetes mellitus has not been established. This study compares the strengths of the associations between different baseline blood pressure variables (systolic blood pressure [SBP], diastolic blood... Full description

Journal Title: Hypertension 2009-08-01, Vol.54 (2), p.399-404
Main Author: Kengne, Andre-Pascal
Other Authors: Czernichow, Sebastien , Huxley, Rachel , Grobbee, Diederick , Woodward, Mark , Neal, Bruce , Zoungas, Sophia , Cooper, Mark , Glasziou, Paul , Hamet, Pavel , Harrap, Stephen B , Mancia, Giuseppe , Poulter, Neil , Williams, Bryan , Chalmers, John , on behalf of ADVANCE Collaborative Group
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Hagerstown, MD: Am Heart Assoc
ID: ISSN: 0194-911X
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recordid: cdi_proquest_miscellaneous_67515761
title: Blood Pressure Variables and Cardiovascular Risk: New Findings From ADVANCE
format: Article
creator:
  • Kengne, Andre-Pascal
  • Czernichow, Sebastien
  • Huxley, Rachel
  • Grobbee, Diederick
  • Woodward, Mark
  • Neal, Bruce
  • Zoungas, Sophia
  • Cooper, Mark
  • Glasziou, Paul
  • Hamet, Pavel
  • Harrap, Stephen B
  • Mancia, Giuseppe
  • Poulter, Neil
  • Williams, Bryan
  • Chalmers, John
  • on behalf of ADVANCE Collaborative Group
subjects:
  • Age Factors
  • Aged
  • Antihypertensive Agents - administration & dosage
  • Area Under Curve
  • Arterial hypertension. Arterial hypotension
  • Biological and medical sciences
  • Blood and lymphatic vessels
  • Blood Glucose - analysis
  • Blood Pressure Determination - methods
  • Cardiology. Vascular system
  • Cardiovascular Diseases - epidemiology
  • Cardiovascular Diseases - etiology
  • Cardiovascular Diseases - prevention & control
  • Clinical manifestations. Epidemiology. Investigative techniques. Etiology
  • Confidence Intervals
  • Diabetes Mellitus, Type 2 - diagnosis
  • Diabetes Mellitus, Type 2 - drug therapy
  • Diabetes Mellitus, Type 2 - epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension - diagnosis
  • Hypertension - drug therapy
  • Hypertension - epidemiology
  • Hypoglycemic Agents - administration & dosage
  • Male
  • Medical sciences
  • Middle Aged
  • Predictive Value of Tests
  • Probability
  • Risk Assessment
  • Severity of Illness Index
  • Sex Factors
  • Survival Rate
  • Time Factors
  • Treatment Outcome
ispartof: Hypertension, 2009-08-01, Vol.54 (2), p.399-404
description: The relative importance of various blood pressure indices on cardiovascular risk in people with type 2 diabetes mellitus has not been established. This study compares the strengths of the associations between different baseline blood pressure variables (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure) and the 4.3-year risk of major cardiovascular events in the Action in Diabetes and Vascular DiseasePreterax and Diamicron-Modified Release Controlled Evaluation Study. Mean (SD) age for the 11 140 participants was 65.8 years (6.4 years). During follow-up, 1000 major cardiovascular events, 559 major coronary events, and 468 cardiovascular deaths were recorded. After adjustment for age, sex, and treatment allocation, the hazard ratios (95% CIs) associated with 1 increment in SD for the risk of major cardiovascular events were 1.17 (1.10 to 1.24) for SBP; 1.20 (1.13 to 1.28) for PP; 1.12 (1.05 to 1.19) for mean arterial pressure; and 1.04 (0.98 to 1.11) for DBP. The areas under the receiver operating characteristic curve were slightly higher for SBP and PP compared with mean arterial pressure and DBP for major cardiovascular and coronary events. Using achieved instead of baseline blood pressure values marginally improved the effect estimates for SBP, DBP, and mean arterial pressure, with no significant differences in the areas under the receiver operating characteristic curve between models with SBP and those with PP. In conclusion, SBP and PP are the 2 best and DBP is the least effective determinant of the risk of major cardiovascular outcomes in the relatively old patients with type 2 diabetes mellitus participating in the Action in Diabetes and Vascular DiseasePreterax and Diamicron-Modified Release Controlled Evaluation Study. However, SBP may be the simplest and most useful predictor across a wider range of age groups and populations.
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titleBlood Pressure Variables and Cardiovascular Risk: New Findings From ADVANCE
creatorKengne, Andre-Pascal ; Czernichow, Sebastien ; Huxley, Rachel ; Grobbee, Diederick ; Woodward, Mark ; Neal, Bruce ; Zoungas, Sophia ; Cooper, Mark ; Glasziou, Paul ; Hamet, Pavel ; Harrap, Stephen B ; Mancia, Giuseppe ; Poulter, Neil ; Williams, Bryan ; Chalmers, John ; on behalf of ADVANCE Collaborative Group
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descriptionThe relative importance of various blood pressure indices on cardiovascular risk in people with type 2 diabetes mellitus has not been established. This study compares the strengths of the associations between different baseline blood pressure variables (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure) and the 4.3-year risk of major cardiovascular events in the Action in Diabetes and Vascular DiseasePreterax and Diamicron-Modified Release Controlled Evaluation Study. Mean (SD) age for the 11 140 participants was 65.8 years (6.4 years). During follow-up, 1000 major cardiovascular events, 559 major coronary events, and 468 cardiovascular deaths were recorded. After adjustment for age, sex, and treatment allocation, the hazard ratios (95% CIs) associated with 1 increment in SD for the risk of major cardiovascular events were 1.17 (1.10 to 1.24) for SBP; 1.20 (1.13 to 1.28) for PP; 1.12 (1.05 to 1.19) for mean arterial pressure; and 1.04 (0.98 to 1.11) for DBP. The areas under the receiver operating characteristic curve were slightly higher for SBP and PP compared with mean arterial pressure and DBP for major cardiovascular and coronary events. Using achieved instead of baseline blood pressure values marginally improved the effect estimates for SBP, DBP, and mean arterial pressure, with no significant differences in the areas under the receiver operating characteristic curve between models with SBP and those with PP. In conclusion, SBP and PP are the 2 best and DBP is the least effective determinant of the risk of major cardiovascular outcomes in the relatively old patients with type 2 diabetes mellitus participating in the Action in Diabetes and Vascular DiseasePreterax and Diamicron-Modified Release Controlled Evaluation Study. However, SBP may be the simplest and most useful predictor across a wider range of age groups and populations.
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subjectAge Factors ; Aged ; Antihypertensive Agents - administration & dosage ; Area Under Curve ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Blood Glucose - analysis ; Blood Pressure Determination - methods ; Cardiology. Vascular system ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cardiovascular Diseases - prevention & control ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Confidence Intervals ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetes Mellitus, Type 2 - epidemiology ; Female ; Follow-Up Studies ; Humans ; Hypertension - diagnosis ; Hypertension - drug therapy ; Hypertension - epidemiology ; Hypoglycemic Agents - administration & dosage ; Male ; Medical sciences ; Middle Aged ; Predictive Value of Tests ; Probability ; Risk Assessment ; Severity of Illness Index ; Sex Factors ; Survival Rate ; Time Factors ; Treatment Outcome
ispartofHypertension, 2009-08-01, Vol.54 (2), p.399-404
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02009 American Heart Association, Inc.
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1Czernichow, Sebastien
2Huxley, Rachel
3Grobbee, Diederick
4Woodward, Mark
5Neal, Bruce
6Zoungas, Sophia
7Cooper, Mark
8Glasziou, Paul
9Hamet, Pavel
10Harrap, Stephen B
11Mancia, Giuseppe
12Poulter, Neil
13Williams, Bryan
14Chalmers, John
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descriptionThe relative importance of various blood pressure indices on cardiovascular risk in people with type 2 diabetes mellitus has not been established. This study compares the strengths of the associations between different baseline blood pressure variables (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure) and the 4.3-year risk of major cardiovascular events in the Action in Diabetes and Vascular DiseasePreterax and Diamicron-Modified Release Controlled Evaluation Study. Mean (SD) age for the 11 140 participants was 65.8 years (6.4 years). During follow-up, 1000 major cardiovascular events, 559 major coronary events, and 468 cardiovascular deaths were recorded. After adjustment for age, sex, and treatment allocation, the hazard ratios (95% CIs) associated with 1 increment in SD for the risk of major cardiovascular events were 1.17 (1.10 to 1.24) for SBP; 1.20 (1.13 to 1.28) for PP; 1.12 (1.05 to 1.19) for mean arterial pressure; and 1.04 (0.98 to 1.11) for DBP. The areas under the receiver operating characteristic curve were slightly higher for SBP and PP compared with mean arterial pressure and DBP for major cardiovascular and coronary events. Using achieved instead of baseline blood pressure values marginally improved the effect estimates for SBP, DBP, and mean arterial pressure, with no significant differences in the areas under the receiver operating characteristic curve between models with SBP and those with PP. In conclusion, SBP and PP are the 2 best and DBP is the least effective determinant of the risk of major cardiovascular outcomes in the relatively old patients with type 2 diabetes mellitus participating in the Action in Diabetes and Vascular DiseasePreterax and Diamicron-Modified Release Controlled Evaluation Study. However, SBP may be the simplest and most useful predictor across a wider range of age groups and populations.
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2Antihypertensive Agents - administration & dosage
3Area Under Curve
4Arterial hypertension. Arterial hypotension
5Biological and medical sciences
6Blood and lymphatic vessels
7Blood Glucose - analysis
8Blood Pressure Determination - methods
9Cardiology. Vascular system
10Cardiovascular Diseases - epidemiology
11Cardiovascular Diseases - etiology
12Cardiovascular Diseases - prevention & control
13Clinical manifestations. Epidemiology. Investigative techniques. Etiology
14Confidence Intervals
15Diabetes Mellitus, Type 2 - diagnosis
16Diabetes Mellitus, Type 2 - drug therapy
17Diabetes Mellitus, Type 2 - epidemiology
18Female
19Follow-Up Studies
20Humans
21Hypertension - diagnosis
22Hypertension - drug therapy
23Hypertension - epidemiology
24Hypoglycemic Agents - administration & dosage
25Male
26Medical sciences
27Middle Aged
28Predictive Value of Tests
29Probability
30Risk Assessment
31Severity of Illness Index
32Sex Factors
33Survival Rate
34Time Factors
35Treatment Outcome
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8Glasziou, Paul
9Hamet, Pavel
10Harrap, Stephen B
11Mancia, Giuseppe
12Poulter, Neil
13Williams, Bryan
14Chalmers, John
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authorKengne, Andre-Pascal ; Czernichow, Sebastien ; Huxley, Rachel ; Grobbee, Diederick ; Woodward, Mark ; Neal, Bruce ; Zoungas, Sophia ; Cooper, Mark ; Glasziou, Paul ; Hamet, Pavel ; Harrap, Stephen B ; Mancia, Giuseppe ; Poulter, Neil ; Williams, Bryan ; Chalmers, John ; on behalf of ADVANCE Collaborative Group
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1Aged
2Antihypertensive Agents - administration & dosage
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4Arterial hypertension. Arterial hypotension
5Biological and medical sciences
6Blood and lymphatic vessels
7Blood Glucose - analysis
8Blood Pressure Determination - methods
9Cardiology. Vascular system
10Cardiovascular Diseases - epidemiology
11Cardiovascular Diseases - etiology
12Cardiovascular Diseases - prevention & control
13Clinical manifestations. Epidemiology. Investigative techniques. Etiology
14Confidence Intervals
15Diabetes Mellitus, Type 2 - diagnosis
16Diabetes Mellitus, Type 2 - drug therapy
17Diabetes Mellitus, Type 2 - epidemiology
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19Follow-Up Studies
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21Hypertension - diagnosis
22Hypertension - drug therapy
23Hypertension - epidemiology
24Hypoglycemic Agents - administration & dosage
25Male
26Medical sciences
27Middle Aged
28Predictive Value of Tests
29Probability
30Risk Assessment
31Severity of Illness Index
32Sex Factors
33Survival Rate
34Time Factors
35Treatment Outcome
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abstractThe relative importance of various blood pressure indices on cardiovascular risk in people with type 2 diabetes mellitus has not been established. This study compares the strengths of the associations between different baseline blood pressure variables (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure) and the 4.3-year risk of major cardiovascular events in the Action in Diabetes and Vascular DiseasePreterax and Diamicron-Modified Release Controlled Evaluation Study. Mean (SD) age for the 11 140 participants was 65.8 years (6.4 years). During follow-up, 1000 major cardiovascular events, 559 major coronary events, and 468 cardiovascular deaths were recorded. After adjustment for age, sex, and treatment allocation, the hazard ratios (95% CIs) associated with 1 increment in SD for the risk of major cardiovascular events were 1.17 (1.10 to 1.24) for SBP; 1.20 (1.13 to 1.28) for PP; 1.12 (1.05 to 1.19) for mean arterial pressure; and 1.04 (0.98 to 1.11) for DBP. The areas under the receiver operating characteristic curve were slightly higher for SBP and PP compared with mean arterial pressure and DBP for major cardiovascular and coronary events. Using achieved instead of baseline blood pressure values marginally improved the effect estimates for SBP, DBP, and mean arterial pressure, with no significant differences in the areas under the receiver operating characteristic curve between models with SBP and those with PP. In conclusion, SBP and PP are the 2 best and DBP is the least effective determinant of the risk of major cardiovascular outcomes in the relatively old patients with type 2 diabetes mellitus participating in the Action in Diabetes and Vascular DiseasePreterax and Diamicron-Modified Release Controlled Evaluation Study. However, SBP may be the simplest and most useful predictor across a wider range of age groups and populations.
copHagerstown, MD
pubAm Heart Assoc
pmid19470869
doi10.1161/HYPERTENSIONAHA.109.133041