ArticleEuropean heart journal2018
Blood pressure and cardiovascular outcomes in patients with diabetes and high cardiovascular risk.
Article in European heart journal, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 2 of them syntheses that pooled it.
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Who cites it
25 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- [Individualizing antihypertensive therapy in diabetes mellitus. Guidelines of the Austrian Diabetes Association (Update 2026)].Wiener klinische Wochenschrift · 2026Guideline
- [Individualising antihypertensive therapy in patients with diabetes. A guideline by the Austrian Diabetes Association (update 2023)].Wiener klinische Wochenschrift · 2023Guideline
- The effect of glucagon-like peptide-1 receptor agonists liraglutide and semaglutide on cardiovascular and renal outcomes across baseline blood pressure categories: Analysis of the LEADER and SUSTAIN 6 trials.Diabetes, obesity & metabolism · 2020 · on this mapTrial
- Rapid Treatment of Acute Decompensated Heart Failure with Cardiogenic Shock in the Emergency Setting.Cardiology and cardiovascular medicine · 2026Article
- Voice-controlled super-resolution ultrasound imaging and reporting powered by multimodal large language models.NPJ digital medicine · 2026Article
- Blood pressure management in secondary prevention after myocardial infarction.Cardiovascular research · 2025Review
- Systolic blood pressure and risk of cardiovascular disease in normotensive diabetic adults: a prospective cohort study.Endocrine · 2024Article
- Intensive Blood Pressure Lowering in Individuals With Low Diastolic Blood Pressure and Elevated Troponin Levels in SPRINT.Journal of the American Heart Association · 2024Article
- Real-World Systolic and Diastolic Blood Pressure Levels and Cardiovascular Mortality in Patients With Type 2 Diabetes-Results From a Large Registry Cohort in Asia.Journal of the American Heart Association · 2023Article
- The optimal definition and prediction nomogram for left ventricular remodelling after acute myocardial infarction.ESC heart failure · 2023Observational
- Article
- Pulse pressure and all-cause mortality in ischaemic heart failure patients: a prospective cohort study.Annals of medicine · 2022Article
- Association between Coronary Artery Plaque Progression and Liver Fibrosis Biomarkers in Population with Low Calcium Scores.Nutrients · 2022Article
- Article
- Association Between Admission Pulse Pressure and Long-Term Mortality in Elderly Patients With Type 2 Diabetes Mellitus Admitted for Acute Coronary Syndrome: An Observational Cohort Study.Frontiers in cardiovascular medicine · 2022Article
- Influence of hypertension duration and blood pressure levels on cardiovascular disease and all-cause mortality: A large prospective cohort study.Frontiers in cardiovascular medicine · 2022Article
- The diastolic blood pressure J-curve revisited: An update.American heart journal plus : cardiology research and practice · 2021Review
- Are there sex differences in the effect of type 2 diabetes in the incidence and outcomes of myocardial infarction? A matched-pair analysis using hospital discharge data.Cardiovascular diabetology · 2021Observational
- Evaluation of Optimal Diastolic Blood Pressure Range Among Adults With Treated Systolic Blood Pressure Less Than 130 mm Hg.JAMA network open · 2021Article
- Blood pressure and mortality in patients with type 2 diabetes and a recent coronary event in the ELIXA trial.Cardiovascular diabetology · 2020Observational
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 4 countries.
Funding
Abstract
Aims: Optimal blood pressure for prevention of cardiovascular (CV) events in patients with Type 2 diabetes mellitus (T2DM) remains uncertain and there is concern for increased risk with low diastolic blood pressure (DBP). This study analysed the association between blood pressure and CV outcomes in high-risk patients with T2DM. Methods and results: Patients with T2DM and elevated CV risk were enrolled in the Saxagliptin Assessment of Vascular Outcomes Recorded in patients with diabetes mellitus-Thrombolysis in Myocardial Infarction 53 trial. Cardiovascular outcomes were compared in the biomarker subgroup (n = 12 175) after stratification by baseline systolic blood pressure (SBP) and DBP. Adjusted risk was calculated by blood pressure stratum using clinical covariates plus N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity troponin-T (hsTnT). Trends were tested using linear and quadratic models. Adjusted risk of the composite endpoint of CV death, myocardial infarction (MI), or ischaemic stroke showed U-shaped relationships with baseline SBP and DBP (Pquadratic ≤ 0.01) with nadirs at SBP 130-140 or DBP 80-90 mmHg. Diastolic blood pressure <60 mmHg was associated with increased risk of MI (adjusted hazard ratio 2.30; 95% confidence interval 1.50-3.53) relative to DBP 80-90 mmHg. Adjusted odds of hsTnT concentration ≥14 ng/L showed U-shaped relationships with SBP and DBP (Pquadratic ≤ 0.01). The relationships between low DBP, elevated hsTnT, and increased MI remained after exclusion of patients with prior heart failure or NT-proBNP >median, suggesting that the relationship was not due to confounding from diagnosed or undiagnosed heart failure. Conclusions: In patients with diabetes and elevated CV risk, even after extensive adjustment for underlying disease burden, there was a persistent association for low DBP with subclinical myocardial injury and risk of MI.
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Registered trials
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