Literature DB >> 20621928

Lower blood pressure associated with higher mortality in elderly diabetic patients (ZODIAC-12).

Kornelis J J van Hateren1, Gijs W D Landman, Nanne Kleefstra, Klaas H Groenier, Adriaan M Kamper, Sebastiaan T Houweling, Henk J G Bilo.   

Abstract

OBJECTIVE: to investigate the relationship between blood pressure over time and mortality in elderly patients with type 2 diabetes mellitus (T2DM).
DESIGN: prospective observational cohort study.
SETTING: primary care, Zwolle, The Netherlands.
SUBJECTS: patients with T2DM aged 60 years and older (n = 881). The cohort was divided into two age categories: 60-75 years and older than 75 years.
METHODS: updated means for systolic, diastolic and pulse pressures were calculated after a median follow-up time of 9.8 years. These values were used as time-dependent covariates in a Cox proportional hazard model. Main outcome measures were all-cause and cardiovascular mortality.
RESULTS: all of the blood pressure measures were inversely related to all-cause mortality in elderly diabetic patients (>75 years). Furthermore, these relationships were specifically found in elderly patients treated with antihypertensive medication at baseline. A decrease of 10 mm Hg in systolic blood pressure, diastolic blood pressure and pulse pressure led to a mortality increase of 22% [95% confidence interval (95% CI): 13-31%], 30% [95% CI: 13%-46%] and 22% [95% CI: 11%-33%], respectively. In the low age group (60-75 years), no relationship was found between blood pressure and mortality.
CONCLUSIONS: blood pressure is a marker for mortality in elderly T2DM patients; however, the relationship is inverse.

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Year:  2010        PMID: 20621928     DOI: 10.1093/ageing/afq080

Source DB:  PubMed          Journal:  Age Ageing        ISSN: 0002-0729            Impact factor:   10.668


  14 in total

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7.  The midregional fragment of pro-A-type natriuretic peptide, blood pressure, and mortality in a prospective cohort study of patients with type 2 diabetes (ZODIAC-25).

Authors:  Kornelis J J van Hateren; Gijs W D Landman; Nanne Kleefstra; Klaas H Groenier; Joachim Struck; Gerjan J Navis; Stephan J L Bakker; Sebastiaan T Houweling; Klaas van der Meer; Henk J G Bilo
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9.  Comment on: Rogers et al. Blood pressure trajectories prior to death in patients with diabetes. Diabetes Care 2011;34:1534-1539.

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10.  Blood pressure trajectories prior to death in patients with diabetes.

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