Study finds monotonic relationship between systolic blood pressure and risk of CV outcomes in diabetes patients
UK: In a recent study published in the journal Hypertension, researchers from the UK, using deep learning modeling, have found a monotonic relationship between systolic blood pressure (SBP) and the risk of cardiovascular (CV) outcomes in diabetes patients without evidence of a J-shaped relationship.
There is a controversy on whether the association between systolic blood pressure and cardiovascular disease (CVD) risk is monotonic or whether there is a nadir of optimal blood pressure. Kazem Rahimi from the University of Oxford in Oxford, UK, and colleagues investigated the association between systolic blood pressure and CV events in diabetes patients across the full spectrum of SBP.
For this purpose, the researchers identified a cohort of 49 000 patients with diabetes aged 50 to 90 years from linked electronic health records in the UK. A deep learning approach was used to analyze the associations between systolic blood pressure and cardiovascular outcomes (heart failure, ischemic heart disease, cardiovascular death, and stroke).
The authors reported the following findings:
· The authors observed 16 378 cardiovascular events over a median follow-up of 7.3 years.
· The relationship between systolic blood pressure and CV events followed a monotonic pattern; the group with the lowest baseline SBP of <120 mm Hg showed the lowest risk of CV events.
· In comparison to the reference group with the lowest systolic blood pressure of less than 120 mm Hg, the adjusted risk ratio for CVD was 1.03 for SBP between 120 and 129 mm Hg, 1.08 for SBP between 140 and 149 mm Hg, 1.05 for SBP between 130 and 139 mm Hg, 1.19 for SBP ≥160 mm Hg, and 1.12 for SBP between 150 and 159 mm Hg.
"We found a monotonic relationship between systolic blood pressure and risk of CV outcomes using deep learning modeling in diabetes patients without evidence of a J-shaped relationship," the authors concluded.
Reference:
Rao S, Li Y, Nazarzadeh M, Canoy D, Mamouei M, Hassaine A, Salimi-Khorshidi G, Rahimi K. Systolic Blood Pressure and Cardiovascular Risk in Patients With Diabetes: A Prospective Cohort Study. Hypertension. 2022 Dec 30. doi: 10.1161/HYPERTENSIONAHA.122.20489. Epub ahead of print. PMID: 36583386.
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