Systolic Blood Pressure, Cardiovascular Mortality, and All-Cause Mortality in Normoglycemia, Prediabetes, and Diabetes
Chao-Lei Chen,1,* Lin Liu,1,* Jia-Yi Huang,1 Yu-Ling Yu,1 Kenneth Lo,1,2 Yu-Qing Huang,1 Ying-Qing Feng1 1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdon...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-07-01
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| Series: | Diabetes, Metabolic Syndrome and Obesity |
| Subjects: | |
| Online Access: | https://www.dovepress.com/systolic-blood-pressure-cardiovascular-mortality-and-all-cause-mortali-peer-reviewed-article-DMSO |
| _version_ | 1797935048844902400 |
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| author | Chen CL Liu L Huang JY Yu YL Lo K Huang YQ Feng YQ |
| author_facet | Chen CL Liu L Huang JY Yu YL Lo K Huang YQ Feng YQ |
| author_sort | Chen CL |
| collection | DOAJ |
| description | Chao-Lei Chen,1,* Lin Liu,1,* Jia-Yi Huang,1 Yu-Ling Yu,1 Kenneth Lo,1,2 Yu-Qing Huang,1 Ying-Qing Feng1 1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, People’s Republic of China; 2Centre for Global Cardiometabolic Health, Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA*These authors contributed equally to this workCorrespondence: Yu-Qing Huang; Ying-Qing FengDepartment of Cardiology,Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, People’s Republic of ChinaTel/ Fax +86-20-83827812Email hyq513@126.com; 651792209@qq.comBackground: The optimal blood pressure (BP) level for diabetic patients remains controversial, while studies provided limited evidence on BP management for individuals with normoglycemia or prediabetes. We aimed to investigate the associations between systolic blood pressure (SBP) and all-cause and cardiovascular (CVD) mortality among US adults with different glycemic profiles.Methods: We used data from the 1999– 2014 National Health and Nutrition Examination Survey (NHANES, n=40,046) with comprehensive baseline examination and follow-up assessment. Restricted cubic spline analysis was performed to examine dose–response relationship between SBP and mortality risk. Cox regression models were used to estimate hazard ratios of all-cause mortality and CVD mortality for SBP categories.Results: U-shaped associations between SBP and all-cause mortality were observed regardless of glucose status. The relationship between SBP and CVD mortality was found to be U-shaped only in normoglycemic participants. The lowest mortality risk of optimal SBP (mmHg) by group was 115– 120 (normoglycemia), 120– 130 (prediabetes), and 125– 135 (diabetes). When compared with the reference group, SBP < 100 mmHg was significantly associated with 49% (HR=1.49, 95% CI: 1.13– 1.96), 57% (1.57, 1.07– 2.3), and 59% (1.59, 1.12– 2.25) higher all-cause mortality risk in people with normoglycemia, prediabetes, and diabetes, respectively. The multivariable-adjusted HRs of all-cause mortality for SBP ≥ 150 mmHg were 1.51 (1.25– 1.82), 1.56 (1.27– 1.93), and 1.33 (1.08– 1.64), respectively. As for CVD mortality, the multivariable-adjusted HRs were 2.85 (1.29– 6.33) for SBP < 100 mmHg and 2.71 (1.56– 4.69) for SBP ≥ 150 mmHg in normoglycemia; HR was 1.66 (1.05– 2.63) for SBP ≥ 150 mmHg in diabetic patients.Conclusion: U-shaped relationships between SBP and all-cause mortality were observed regardless of diabetes status. The optimal SBP range was gradually higher with worsening glucose status.Keywords: systolic blood pressure, mortality, normoglycemia, prediabetes, diabetes mellitus |
| first_indexed | 2024-04-10T18:08:26Z |
| format | Article |
| id | doaj.art-9a816352e77b426d8f095f172f321511 |
| institution | Directory Open Access Journal |
| issn | 1178-7007 |
| language | English |
| last_indexed | 2024-04-10T18:08:26Z |
| publishDate | 2020-07-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Diabetes, Metabolic Syndrome and Obesity |
| spelling | doaj.art-9a816352e77b426d8f095f172f3215112023-02-02T11:50:02ZengDove Medical PressDiabetes, Metabolic Syndrome and Obesity1178-70072020-07-01Volume 132375238855085Systolic Blood Pressure, Cardiovascular Mortality, and All-Cause Mortality in Normoglycemia, Prediabetes, and DiabetesChen CLLiu LHuang JYYu YLLo KHuang YQFeng YQChao-Lei Chen,1,* Lin Liu,1,* Jia-Yi Huang,1 Yu-Ling Yu,1 Kenneth Lo,1,2 Yu-Qing Huang,1 Ying-Qing Feng1 1Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, People’s Republic of China; 2Centre for Global Cardiometabolic Health, Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA*These authors contributed equally to this workCorrespondence: Yu-Qing Huang; Ying-Qing FengDepartment of Cardiology,Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou 510080, People’s Republic of ChinaTel/ Fax +86-20-83827812Email hyq513@126.com; 651792209@qq.comBackground: The optimal blood pressure (BP) level for diabetic patients remains controversial, while studies provided limited evidence on BP management for individuals with normoglycemia or prediabetes. We aimed to investigate the associations between systolic blood pressure (SBP) and all-cause and cardiovascular (CVD) mortality among US adults with different glycemic profiles.Methods: We used data from the 1999– 2014 National Health and Nutrition Examination Survey (NHANES, n=40,046) with comprehensive baseline examination and follow-up assessment. Restricted cubic spline analysis was performed to examine dose–response relationship between SBP and mortality risk. Cox regression models were used to estimate hazard ratios of all-cause mortality and CVD mortality for SBP categories.Results: U-shaped associations between SBP and all-cause mortality were observed regardless of glucose status. The relationship between SBP and CVD mortality was found to be U-shaped only in normoglycemic participants. The lowest mortality risk of optimal SBP (mmHg) by group was 115– 120 (normoglycemia), 120– 130 (prediabetes), and 125– 135 (diabetes). When compared with the reference group, SBP < 100 mmHg was significantly associated with 49% (HR=1.49, 95% CI: 1.13– 1.96), 57% (1.57, 1.07– 2.3), and 59% (1.59, 1.12– 2.25) higher all-cause mortality risk in people with normoglycemia, prediabetes, and diabetes, respectively. The multivariable-adjusted HRs of all-cause mortality for SBP ≥ 150 mmHg were 1.51 (1.25– 1.82), 1.56 (1.27– 1.93), and 1.33 (1.08– 1.64), respectively. As for CVD mortality, the multivariable-adjusted HRs were 2.85 (1.29– 6.33) for SBP < 100 mmHg and 2.71 (1.56– 4.69) for SBP ≥ 150 mmHg in normoglycemia; HR was 1.66 (1.05– 2.63) for SBP ≥ 150 mmHg in diabetic patients.Conclusion: U-shaped relationships between SBP and all-cause mortality were observed regardless of diabetes status. The optimal SBP range was gradually higher with worsening glucose status.Keywords: systolic blood pressure, mortality, normoglycemia, prediabetes, diabetes mellitushttps://www.dovepress.com/systolic-blood-pressure-cardiovascular-mortality-and-all-cause-mortali-peer-reviewed-article-DMSOsystolic blood pressuremortalitynormoglycemiaprediabetesdiabetes mellitus |
| spellingShingle | Chen CL Liu L Huang JY Yu YL Lo K Huang YQ Feng YQ Systolic Blood Pressure, Cardiovascular Mortality, and All-Cause Mortality in Normoglycemia, Prediabetes, and Diabetes Diabetes, Metabolic Syndrome and Obesity systolic blood pressure mortality normoglycemia prediabetes diabetes mellitus |
| title | Systolic Blood Pressure, Cardiovascular Mortality, and All-Cause Mortality in Normoglycemia, Prediabetes, and Diabetes |
| title_full | Systolic Blood Pressure, Cardiovascular Mortality, and All-Cause Mortality in Normoglycemia, Prediabetes, and Diabetes |
| title_fullStr | Systolic Blood Pressure, Cardiovascular Mortality, and All-Cause Mortality in Normoglycemia, Prediabetes, and Diabetes |
| title_full_unstemmed | Systolic Blood Pressure, Cardiovascular Mortality, and All-Cause Mortality in Normoglycemia, Prediabetes, and Diabetes |
| title_short | Systolic Blood Pressure, Cardiovascular Mortality, and All-Cause Mortality in Normoglycemia, Prediabetes, and Diabetes |
| title_sort | systolic blood pressure cardiovascular mortality and all cause mortality in normoglycemia prediabetes and diabetes |
| topic | systolic blood pressure mortality normoglycemia prediabetes diabetes mellitus |
| url | https://www.dovepress.com/systolic-blood-pressure-cardiovascular-mortality-and-all-cause-mortali-peer-reviewed-article-DMSO |
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