A prognostic role of mean 24-h pulse pressure level for cardiovascular events in type 2 diabetic subjects under 60 years of age

Diabetes Care. 2005 Jan;28(1):95-100. doi: 10.2337/diacare.28.1.95.

Abstract

Objective: To assess the prognostic role of ambulatory 24-h pulse pressure (PP) on various vascular events in relatively young type 2 diabetic subjects under 60 years of age.

Research design and methods: In this prospective study, 237 type 2 diabetic subjects without any history of vascular complications were analyzed. After excluding 9 dropout subjects, 228 subjects (mean age, 46 years; 69% men; mean follow-up period, 100 months) entered the study.

Results: Distribution of 24-h PP for all subjects showed left skewed data, indicating that there may be a diabetic subgroup that had a wide PP. Therefore, further analysis was performed by stratifying the diabetic subjects by quartile of 24-h PP. Outcomes for the widest quartile (n = 58; cut point = 53.3 mmHg) was then compared with those from the other narrower quartiles (n = 170). In the diabetic subjects with a wide PP, cardiovascular events occurred more frequently than those in the diabetic subjects with a narrow one (20.7 vs. 4.1%; P < 0.001), resulting in the significant difference in the cumulative incidence of cardiovascular events (P < 0.001, log-rank test), but not cerebrovascular events, between the two subgroups. The Cox model revealed that a wide 24-h PP at baseline independently predicted subsequent cardiovascular events but not cerebrovascular events. By contrast, only duration of diabetes was the risk factor for cerebrovascular events.

Conclusions: This study showed that a wide 24-h PP is predictive for cardiovascular events in relatively young diabetic subjects.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Blood Pressure / physiology*
  • Blood Pressure Determination / methods
  • Blood Pressure Monitoring, Ambulatory / methods
  • Cardiovascular Diseases / epidemiology
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetic Angiopathies / epidemiology*
  • Female
  • Follow-Up Studies
  • Heart Rate / physiology*
  • Humans
  • Male
  • Middle Aged
  • Patient Selection
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Pulse*
  • Time Factors