ArticleJournal of the American Heart Association2025
Blood Pressure and Cardiovascular Outcomes in Adults With Diabetes and Chronic Kidney Disease.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCurrent hypertension guidelines recommend intensive blood pressure (BP) targets (eg, <130/80 mm Hg) for patients with diabetes and chronic kidney disease. However, data supporting these recommendations are limited.
methodsFrom Korean nationwide health screening and claims data, we identified 373 966 adults with both diabetes and chronic kidney disease who (1) underwent a baseline health examination in 2009 to 2013; (2) had ≥3 BP-measuring visits during a 5-year look-back period; and (3) did not have prior cardiovascular disease (CVD). The mean of all BPs measured throughout the look-back period was used for the analysis. The primary outcome was CVD event, defined as a composite of myocardial infarction, stroke, heart failure, or death from CVD.
resultsOver a median follow-up of 10.2 years, 40 781 CVD events occurred. When using systolic BP 130 to <140 mm Hg as the reference, multivariable-adjusted hazard ratios (HRs) for CVD event in the systolic BP ≥150, 140 to <150, 120 to <130, and <120 mm Hg groups were 1.34 (95% CI, 1.29-1.39), 1.11 (95% CI, 1.08-1.14), 0.89 (95% CI, 0.87-0.91), and 0.77 (95% CI, 0.74-0.80), respectively. When using diastolic BP 80 to <90 mm Hg as the reference, HRs in the diastolic BP ≥100, 90 to <100, 70 to <80, and <70 mm Hg groups were 1.70 (95% CI, 1.56-1.85), 1.19 (95% CI, 1.15-1.24), 0.88 (95% CI, 0.86-0.90), and 0.83 (95% CI, 0.80-0.87), respectively. Systolic BP <130 mm Hg and diastolic BP <80 mm Hg were each associated with reduced CVD risk in a log-linear pattern.
conclusionsAmong patients with diabetes and chronic kidney disease, SBP <130 mm Hg and diastolic BP <80 mm Hg were associated with reduced risk of CVD.
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