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Pulse Pressure Linked To Cardiovascular Mortality Among Type 2 Diabetics
A DGReview of :"Diabetes, pulse pressure and cardiovascular mortality: the Hoorn Study."
Journal of Hypertension
09/03/2002
By Andrew A. Skolnick
High pulse pressure is associated with increased cardiovascular mortality in patients with type 2 diabetes.
M. T. Schram and colleagues at the Vrije Universiteit Medical Centre, in Amsterdam, the Netherlands, studied the relationship between pulse pressure -- an indicator of vascular stiffness -- and risk of cardiovascular mortality among type 2 diabetic and non-diabetic subjects.
They followed a cohort of 2,484 individuals who were part of the Hoorn Study, which was begun in 1989 to investigate the prevalence and determinants of type 2 diabetes in the general Dutch population.
The cohort included 208 type 2 diabetic patients. Mean follow-up for diabetic subjects was 8.6 years and 8.8 years for non-diabetics.
Relative risks of cardiovascular mortality were estimated by Cox proportional hazards regression adjusted for age, gender and mean arterial pressure, the researchers reported.
During follow-up, 34 diabetics and 116 non-diabetics died of cardiovascular causes. The investigators found pulse pressure was associated with cardiovascular mortality among the diabetic, but not among non-diabetic individuals.
Further adjustment for other risk factors gave similar results. The association between age and pulse pressure at baseline was dependent on the presence of diabetes and on the mean arterial pressure. There was a stronger association when diabetes was present or when mean arterial pressure was higher, the investigators noted.
"We conclude that, in type 2 diabetes, pulse pressure is positively associated with cardiovascular mortality," the researchers concluded. "The association between age and pulse pressure is influenced by the presence of type 2 diabetes and by the height of the mean arterial pressure. These findings support the concept of accelerated vascular aging in type 2 diabetes."
J Hypertens 2002; 20: 1743-1751
"Diabetes, pulse pressure and cardiovascular mortality: the Hoorn Study."
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