Abstract P216: Blood Pressure Level as Predictor for Developing Diabetes Type 2

Introduction and Aim: The link between diabetes type 2 and hypertension is a well established with both factors parts of the metabolic syndrome. Whether hypertension is an independent predictor for diabetes type 2 development has been examined in previous studies, however with divergent findings. The aim of this study was to investigate whether hypertension, including mildly elevated blood pressure within the normal range predicted subsequent development of diabetes type 2 over an extended follow-up. Methods and Results: Data were derived from participants of the intervention group of the Gothenburg primary prevention study where a random sample of 7333 men aged 47-55 years and free of diagnosed diabetes underwent a screening investigation in 1970 to 1973. During a 32-year follow-up, 956 men (13%) were diagnosed with diabetes according to the Swedish hospital discharge register. Development of diabetes type 2 was positively correlated to age, BMI, systolic blood pressure (SBP) and diastolic blood pressure (DBP), serum cholesterol, hypertension treatment, non-manual occupation, high tobacco use, sedentary lifestyle at the midlife screening. In a Cox regression model which adjusted for BMI and other risk factors we calculated the multiple adjusted hazard ratio for developing diabetes type 2 according to blood pressure level. Compared to a reference level of systolic blood pressure (SBP) below 130 mm Hg, men with SBP of 130-139 mmHg, 140-149 mmHg and > 150 mmHg had a multiple adjusted hazard ratios (HRs) of 1.41 (95% confidence interval) 1.11–1.80), 1.38 (1.08–1.75) and 1.67 (1.35–2.07), respectively. Mid-life diastolic blood pressure over 90 mmHg was associated to an increased risk of developing diabetes type 2 (multiple adjust HRs of 1,60 1,21–2,11) Conclusion: In this population, at mid-life, hypertension as well as moderately elevated systolic blood pressure levels within the normal range was shown to be independent predictors of diabetes type 2.

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Abstract P036: Socioeconomic Status and Risk of Diabetes over 35 Years

Circulation ◽

10.1161/circ.125.suppl_10.ap036 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Lena M Bjorck ◽

Christina Stahl-Heden ◽

Masuma Novak ◽

Wai Giang Kok ◽

Annika Rosengren

Keyword(s):

Socioeconomic Status ◽

Population Sample ◽

Diabetes Type 2 ◽

Diabetes Type ◽

Low Ses ◽

Occupational Class ◽

Skilled Workers ◽

Unskilled Workers

Background and aim: The link between low socioeconomic status (SES) and CHD is well established but whether low SES is also an independent predictor for development of diabetes type 2 is not clear. The aim of this study was to investigate whether SES, measured as occupational class, predicted subsequent development of diabetes type 2 over an extended follow-up. Methods: A total of 6941 men 47-55 years old, without prior diabetes, from a population sample of 9998 men, were investigated during 1970-73. Of the men, 23.7% were unskilled workers, 27.2% were skilled workers, 19.7% occupied either a supervisory manual position or were lower officials, 17.9% were officials at an intermediate position, and 11.6% were professionals, executives or senior officials. Follow-up was achieved through the national Swedish patient registry. Results: A total of 900 men (13%) were registered at any time with a diagnosis of diabetes over a 35-year follow-up. Compared with men in the highest occupational class, men with intermediate non-manual occupations had a multiple-adjusted hazard ratio (HR) of 1.10, 95% confidence interval (CI) 0.84-1.44, lower officials and foremen had an HR of 1.37 (1.06-1.78), semiskilled and skilled workers 1.39 (1.08-1.78), and unskilled workers 1.66 (1.30-2.13) after adjustment for smoking at baseline, BMI, blood pressure, serum cholesterol, treatment for hypertension and leisure time physical activity. Conclusions: Low SES is an independent risk factor for long-term risk of diabetes in men, with a 66% independent higher risk in unskilled workers, compared to professionals/senior officials.

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Differences in Blood Pressure Level and Hypertension in Three Ethnic Groups of Northeastern India

Asia Pacific Journal of Public Health ◽

10.1177/101053950001200204 ◽

2000 ◽

Vol 12 (2) ◽

pp. 71-78 ◽

Cited By ~ 10

Author(s):

N.C. Hazarika ◽

D. Biswas ◽

K. Narain ◽

R.K. Phukan ◽

H.C. Kalita ◽

...

Keyword(s):

Blood Pressure ◽

Body Mass Index ◽

Waist Circumference ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Ethnic Groups ◽

Body Mass ◽

Alcohol Intake ◽

Blood Pressure Level ◽

Tea Garden

A cross sectional study on hypertension was done on 294 subjects aged 30 years and above. 150 households were selected randomly representing 50 households from each locality inhabited exclusively by the rural Mizos, indigenous rural Assamese and the tea-garden workers respectively, in the northeastern region of India. Blood pressure was measured by sphygmo-manorneter in sitting posture. Anthro-pometric measurements were taken using standard procedure for measuring height, weight, waist and hip girth. Information on age, sex, ethnicity, literacy, alcohol intake, smoking pattern, physical activity, occupation, amount of salt consumption was collected using a standard and pre-tested questionnaire. Significant differences were observed in both the systolic and diastolic blood pressure levels among the three different ethnic groups selected for this study ( p<0.0001). Multiple regression analyses indicated that in Mizos, age, waist circumference and alcohol intake were independently associated with increase in systolic blood pressure whereas smoking was found to be negatively associated with systolic blood pressure ( R2=0.391, p<0.001). Factors, which were the best predictors of diastolic blood pressure, were age and body mass index [(kg/m2) ( R2=0.227, p<0.001)]. In the rural Assamese population, the best predictors of systolic blood pressure were age and waist circumference ( R2=0.263, p=0.018). For the diastolic blood pressure, age, alcohol intake and body mass index were important correlates ( R2 = 0.131, p<0.001). In the tea garden community, important predictors of systolic blood pressure were age, gender and marital status ( R2=0.187, p<0.001). On the other hand, age and alcohol intake were best predictors for diastolic blood pressure ( R2=0.09, p<0.001). Asia Pac J Public Health 2000,-12(2): 71-78

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Assessing Children's Blood Pressure—Considerations of Age and Body Size: The Muscatine Study

PEDIATRICS ◽

10.1542/peds.75.6.1081 ◽

1985 ◽

Vol 75 (6) ◽

pp. 1081-1090

Author(s):

Ronald M. Lauer ◽

Trudy L. Burns ◽

William R. Clarke

Keyword(s):

Blood Pressure ◽

Body Weight ◽

Body Size ◽

Systolic Blood Pressure ◽

High Blood Pressure ◽

Clinical Setting ◽

Blood Pressure Level ◽

Pressure Level ◽

Excessive Body Weight

Blood pressure was assessed in 4,207 children, aged 5 to 18 years, examined in the schools of Muscatine, Iowa during 1981. Overall, 69.9% of the age-sex-specific quintiles and height-sex-specific quintiles of systolic blood pressure were identical. In only 1.0% of children did these quintiles differ by more than one. Children whose blood pressure was in the highest quintile for both age and height were more obese than their peers. Those whose blood pressure was high for age but not for height were proportionately taller and heavier than their age peers. Children whose blood pressure was high for height but not for age were older, shorter, and lighter. Thus, having precocious levels of blood pressure for age during childhood is associated with excessive body weight or precocious height, whereas having high blood pressure for height but not for age is associated with being short for age. The latter suggests that age may be a factor independent of height and weight affecting blood pressure level in childhood. These relationships of body size and age to blood pressure must be considered when evaluating children's blood pressure levels in the clinical setting, and a technique for doing so is presented.

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INFLUENCE OF DIABETES TYPE 2 ON INDEXES OF AMBULATORY BLOOD PRESSURE AMBULATORY AT PATIENTS WITH MULTIPLE DAMAGE OF CORONARY ARTERIES: PP.17.168

Journal of Hypertension ◽

10.1097/01.hjh.0000379094.15307.0e ◽

2010 ◽

Vol 28 ◽

pp. e299-e300

Author(s):

V Romanov ◽

A Logvinenko ◽

I Chulayevskaya

Keyword(s):

Blood Pressure ◽

Coronary Arteries ◽

Ambulatory Blood Pressure ◽

Diabetes Type 2 ◽

Diabetes Type

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A Meta-Analysis on the Effect and Safety of LCZ696 in the Treatment of Hypertension

Cardiology Research and Practice ◽

10.1155/2021/8867578 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Li Zheng ◽

Binbin Xia ◽

Xuqian Zhang ◽

Yan Zhao

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Angiotensin Receptor Blockers ◽

Meta Analysis ◽

Blood Pressure Level ◽

Evaluation Standard ◽

Treatment Of Hypertension ◽

Patient Will ◽

Receptor Blockers

Objectives. To systematically evaluate the differences in effect and safety of LCZ696 and angiotensin receptor blockers (ARBs) in the treatment of hypertension. Methods. We searched PubMed, Cochrane, Web of Science, and Ovid, collected randomized controlled trials (RCTs) about the effect and safety of LCZ696 and ARBs in hypertensive patients, extracted relevant data and evaluated the quality of the included literature according to the RCT quality evaluation standard recommended by Cochrane Reviewer’s Handbook, using RevMan 5.3, and performed meta-analysis. Results. Eight RCTs studies were included, with a total of 4313 patients. Compared with ARBs, LCZ696 can better reduce systolic blood pressure (msSBP) (WMD −4.29 mmHg; 95% CI: −5.37 to −3.21; P < 0.001), diastolic blood pressure (msDBP) (WMD −1.87 mmHg; 95% CI:−2.38 to −1.36; P < 0.01), ambulatory systolic blood pressure (maSBP) (WMD −3.37 mmHg; 95% CI:−4.26 to −2.47; P < 0.01), and ambulatory diastolic blood pressure (maDBP) (WMD −1.47 mmHg; 95% CI: −1.97 to −0.97; P < 0.01). In terms of safety, LCZ696 is basically the same as ARBs, but LCZ696 is more likely to cause cough than ARBs (OR = 2.38; 95% CI: 1.27 to 4.47; P < 0.01). Conclusion. LCZ696 can significantly reduce the blood pressure level of patients with hypertension, but it is necessary to pay attention to whether the patient will experience coughing after taking the drug.

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Surgical repair of the moderately dilated ascending aorta combined with bicuspid aortic valve replacement

Almanac of Clinical Medicine ◽

10.18786/2072-0505-2019-47-041 ◽

2019 ◽

Vol 47 (4) ◽

pp. 299-309

Author(s):

V. E. Uspenskiy ◽

E. G. Malev ◽

N. D. Gavriliuk ◽

B. K. Salavatov ◽

S. A. Ermolov ◽

...

Keyword(s):

Blood Pressure ◽

Aortic Valve ◽

Aortic Valve Replacement ◽

Blood Pressure Level ◽

Pressure Level ◽

Increased Risk ◽

Group 2 ◽

Group 1

Background: Ascending aortic (AA) dilatation is common in patients with bicuspid aortic valve (BAV). In BAV replacement, surgery of the AA is indicated in the case if AA diameter exceeds 45 mm. Aortic valve replacement combined with an AA intervention is associated with increased risk of complications. The feasibility of the reduction ascending aortoplasty for correction of the dilated AA remains disputable.Aim: To analyze the results of BAV surgical replacement with simultaneous surgical correction of the borderline AA dilatation (45-50 mm) by the reduction aortoplasty (RAP) or supracoronary AA replacement (SPR).Materials and methods: This single center prospective non-randomized study included 53 patients with significant BAV stenosis and AA dilatation (45-50 mm), divided into 2 groups: BAV surgical replacement combined with RAP AA replacement (group 1, 36 patients) and BAV replacement with SPR (group 2, 17 patients). There were no significant differences between the patients of the two groups in their characteristics of the underlying disease, complications and comorbidities.Results: Hospital mortality was 0%. No between-group differences in the early postoperative course were found. At later term, 44 (81.5%) patients were assessed; median (dispersion) of the follow-up was 36 (25; 50) months. Two patients from the group 2 died during the follow-up. The long-term survival was better in the group 1 (p = 0.028). No differences in the combined adverse event rate were observed between the groups (p = 0.633). The median (dispersion) of the AA absolute increment and the rate of dilatation after RAP were 1.0 (0.0; 3.0) mm and 0.24 (0.00; 0.95) mm/year, respectively. The predictor of AA increment rate ≥ 2 mm/year was the baseline blood pressure level (odds ratio 1.321, 95% confidence interval 1.050-1.662; p=0.017). The threshold preoperative blood pressure value for the increased risk of the long-term AA expansion rate was 138 mmHg.Conclusion: The efficacy and safety of RAP and SRP combined with BAV replacement in AA borderline dilatation are similar. Combined BAV surgery and RAP is effective and safe in patients with systolic blood pressure level ≤ 135 mmHg. Combined BAV replacement with SRP seems reasonable in patients with arterial hypertension.

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Effects of Aggressive Approach to the Multiple Risk Factors for Diabetic Nephropathy on Proteinuria Reduction in Diabetes Type 2 Patients

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2009.2855 ◽

2009 ◽

Vol 9 (1) ◽

pp. 44-48 ◽

Cited By ~ 1

Author(s):

Belma Aščić – Buturović ◽

Mirsad Kacila ◽

Mehmed Kulić

Keyword(s):

Blood Pressure ◽

Smoking Cessation ◽

Diabetes Type 2 ◽

Diabetes Type ◽

Dietary Interventions ◽

Salt Restriction ◽

Multiple Risk Factors ◽

Daily Dose ◽

The Mean

Dietary interventions with protein and salt restriction, good glucose control, smoking cessation, aggressive blood pressure control, good control of cholesterol and triglycerides, use of ACE inhibitors and ARBs can delay the progression of diabetic nephropathy.The aim of this study was to present the effects of aggressive treatment of the multiple risk factors for diabetic nephropathy on proteinuria in patients with type 2 diabetes. In this study we included 15 patients with diabetes type 2 and insufficient regulation of glycaemia. The patients were followed for three months period. Glycated haemoglobin (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPG), blood pressure, cholesterol and triglycerides and proteinuria were followed prior and after the study. Prior the study patients were treated with premix insulin divided in two daily doses + metformin after the lunch and they had insufficient regulation of glycaemia. During the study patients were treated with one daily dose of basal insulin, three doses of metformin (2550 mg), one daily dose of atorvastatin (20 mg) and one daily dose of ramipril (5 to 10 mg). Doses of insulin were titrated separately for each patients (0,7-1,0 IU/kg). Patients were advised to start with lifestyle modification, increased physical activity and dietary interventions with protein and salt restriction, energy restricted diet and smoking cessation. A total of 20 patients (male 12 and female 8) with diabetes type 2 were studied. The mean age of the subjects was 53±5,25 years. The mean diabetes duration was 4,05±1,96 years. The mean body mass index decreased from 28,1±1,67 kg/m2 to 25,9 ±1,22 kg/m2 after the study. Mean HbA1c decreased from 8,82 ± 0,53 % to 7,15 ± 0,23 % (p<0,05). Mean fasting glycemia decreased from 8,79±0,58 mmol/dm3 to 7,03±0,18 mmol/dm3 (p < 0,05). Mean postmeal glycemia decreased from 9,93 ± 0,77 mmol/dm3 to 7,62 ± 0,42 mmol/dm3 (p<0,05). The mean cholesterol level decreased from 7,99 ±0,64 mmol/dm3 to 5,93 ± 0,65 mmol/dm3 (p<0,05). The mean triglicerides level decreased from 4,05 ± 0,97 mmol/dm3 to 1,96 ± 0,24 mmol/dm3 (p<0,05). The significant decrease of proteinuria was recorded, prior the study the mean albuminuria was 1,05 ± 0,31 g/dm3 and after the study was 0,07 ± 0,145 g/dm3 (p<0,05). Mean blood pressure prior the study was 153±8,69/91,5 ± 3,78 mm Hg (p<0,05), after the study was 125 ± 6,32/ 79,25±3,26 mmHg.Effective control of glycaemia, blood pressure, cholesterol and triglycerides, use of ACE inhibitors, dietary interventions with protein and salt restriction, smoking cessation, can delay the progression of nephropathy in type 2 diabetes.

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Predictors of Glycemic Control Among Patients With Type 2 Diabetes in North West Ethiopia: a Longitudinal Study

10.21203/rs.3.rs-288389/v2 ◽

2021 ◽

Author(s):

Nigusie Gashaye Shita ◽

Ashagrie Sharew Iyasu

Keyword(s):

Diabetes Mellitus ◽

Blood Pressure ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Glycemic Control ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Good Glycemic Control ◽

Diabetes Patients

Abstract Background: Type 2 diabetes mellitus patients with hyperglycemia for a long period are significant causes of mortality and morbidity worldwide. Studying the predictors of glycemic control helps to minimize deaths and the development of acute and chronic diabetes complication. Hence, this study aims to assess predictors of glycemic control among patients with Type 2 diabetes in Ethiopia.Methods: A retrospective cohort study was conducted among type 2 Diabetes mellitus (T2DM) patients enrolled between December 2011 and December 2012 at Debre Markos and Felege Hiwot Referral Hospital. A total of 191 T2DM patients were included in the study meets the eligibility criteria. A generalized linear mixed model was employed. Results: The prevalence of good glycemic control among type 2 diabetes patients was 58.4% whereas 23.25% of the variation was explained in the fitted model due to adding the random effects. The significance predictors of glycemic control among patients with Type 2 diabetes at 95% confidence level were reside in rural(0.454, 0.614)), patients age 38-50, 51-59 and 60-66 years(1.267,1.776), (1.057,1.476) and (1.004, 1.403), respectively, Proteinuria Positive (1.211, 1.546), diastolic blood pressure ≥90 (1.101, 1.522), systolic blood pressure ≥140 (1.352, 1.895), creatinine (0.415, 0.660), duration per visit (0.913, 0.987), duration since diagnosis (0.985, 0.998), weight 78-88(0.603, 0.881).Conclusion: The level of glycemic control among type 2 diabetes patients was poor. Type 2 diabetes mellitus patients having higher age of the patient, higher weight, reside in rural, longer duration of T2DM since diagnosis, longer duration of type 2DM per visit, increase creatinine, positive protein urea, diastolic blood pressure≥90, and systolic blood pressure≥140 were significant predictors of poor glycemic control among type 2 DM patients. During diabetic patients follow up, clinicians should give appropriate attention to these significant variables for good glycemic control since it is the main goal of diabetes management.

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