Background: Standard measures of blood pressure (BP) do not account for both the magnitude and duration of exposure to elevated BP over time.
Objectives: The purpose of this study was to assess the association between cumulative systolic blood pressure (SBP) load and risk of cardiovascular events in patients with type 2 diabetes.
Methods: A post hoc analysis of patients with type 2 diabetes followed by the ADVANCE-ON (Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation - Observational Study). Cumulative SBP load was defined as the area under curve for SBP values ≥130 mm Hg divided by the area under curve for all measured SBP values over a 24-month exposure period. HRs for the association between cumulative SBP load with major cardiovascular events and death were estimated using Cox models.
Results: Over a median 7.6 years of follow-up, 1,469 major cardiovascular events, 1,615 deaths, and 660 cardiovascular deaths were observed in 9,338 participants. Each 1-SD increase in cumulative SBP load was associated with a 14% increase in major cardiovascular events (HR: 1.14; 95% CI: 1.09-1.20), 13% increase in all-cause mortality (HR: 1.13; 95% CI: 1.13-1.18), and 21% increase in cardiovascular death (HR: 1.21; 95% CI: 1.13-1.29). For the prediction of cardiovascular events and death, cumulative SBP load outperformed mean SBP, time-below-target SBP, and visit-to-visit SBP variability in terms of Akaike information criterion and net reclassification indexes.
Conclusions: Cumulative SBP load may provide better prediction of major cardiovascular events compared with traditional BP measures among patients with type 2 diabetes. These findings reinforce the importance of both the magnitude and duration of exposure to elevated SBP in assessing cardiovascular risk. (Action in Diabetes and Vascular Disease Preterax and Diamicron MR Controlled Evaluation Post Trial Observational Study [ADVANCE-ON]; NCT00949286).
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jacc.2022.06.039 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Objective: Elevated blood pressure (BP), even at prehypertensive levels, increases cardiovascular disease risk among people with HIV (PWH); yet international guidelines in low-income countries recommend treatment initiation at BP at least 140/90 mmHg. We determined the efficacy, feasibility, and acceptability of treating prehypertension in PWH in Haiti.
Design: An unblinded randomized clinical trial (enrolled April 2021-March 2022) with 12-month follow-up.
Ambulatory blood pressure profiles of children with asthma compared to healthy controls.
Pediatr Nephrol
January 2025
Pediatric Nephrology, Faculty of Medicine, Ankara City Hospital, Ankara Yıldırım Beyazıt University Ankara, Bilkent, Turkey.
Background: Studies suggest that asthma and hypertension may be comorbid conditions. Most of these studies are epidemiological research. However, data on the relationship between asthma and hypertension in childhood are limited.
View Article and Find Full Text PDFL-Arginine Supplementation Did Not Impact the Rapid Recovery of Cardiovascular and Autonomic Function Following Exercise in Physically Active Healthy Males: A Triple-Blind Randomised Placebo-Controlled Crossover Trial.
Nutrients
November 2024
Postgraduate Program in Movement Sciences, Sao Paulo State University (UNESP), Presidente Prudente 19060-900, SP, Brazil.
Background And Aims: Post-exercise recovery strategies include massage, low-intensity active exercise, thermal contrast, hydration, and nutritional and herbal approaches. These strategies aim to accelerate recovery, enhance performance, and optimise the physical training process. L-arginine (L-ARG) is the physiological precursor of nitric oxide (NO), a crucial mediator of vasodilation and the inhibition of platelet aggregation.
View Article and Find Full Text PDFEffects of neuromuscular fatigue induced by various modes of isometric handgrip exercise on post-exercise blood pressure responses.
J Sports Med Phys Fitness
December 2024
Department of Health and Kinesiology, University of Illinois at Urbana-Champaign, Urbana, IL, USA -
Article Synopsis
- - The study investigates how different modes of isometric handgrip exercise (IHE) influence blood pressure responses post-exercise, focusing on exercise duration and muscle mass involvement.
- - Twenty healthy participants performed three types of IHE protocols, and researchers measured neuromuscular fatigue in specific forearm muscles using electromyography.
- - Results showed significant correlations between neuromuscular fatigue in certain muscles and changes in blood pressure immediately after and ten minutes post-exercise, suggesting these factors are linked.
Effectiveness of low-load resistance training with blood flow restriction vs. conventional high-intensity resistance training in older people diagnosed with sarcopenia: a randomized controlled trial.
Sci Rep
November 2024
Department of Rehabilitation, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China.
Low-load resistance training with blood flow restriction (LRT-BFR) has shown potential to improve muscle strength and mass in different populations; however, there remains limited evidence in sarcopenic people diagnosed with sarcopenia criteria. This study systematically compared the effectiveness of LRT-BFR and conventional high-intensity resistance training (CRT) on clinical muscle outcomes (muscle mass, strength and performance), cardiovascular disease (CVD) risk factors and sarcopenia-related biomarkers of older people with sarcopenia. Twenty-one older individuals (aged 65 years and older) diagnosed with sarcopenia were randomly assigned to the LRT-BFR (20%-30% one-repetition maximum (1RM), n = 10) or CRT (60%-70% 1RM, n = 11) group.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!