Key result
High mean and high variability of systolic blood pressure (SBP-Mean ≥ 130, SBP-SD ≥ 11.06) was associated with the highest risk of diabetic kidney disease (HR 1.976, p < 0.001).
Why the study?
The study was conducted to explore the relationship between long-term variabilities in different blood pressure variables and diabetic kidney disease in patients with type 2 diabetes.
Is long-term blood pressure variability associated with the development of diabetic kidney disease in patients with type 2 diabetes?
Cohort (n=3,050)
Is long-term blood pressure variability associated with the development of diabetic kidney disease in patients with type 2 diabetes?
Hazard Ratio: 1.976
p-value: p=<0.001
Higher mean systolic blood pressure and greater long-term blood pressure variability are associated with an increased risk of developing diabetic kidney disease in patients with type 2 diabetes.
High SBP mean and variability associated with DKD risk in T2D; leaves open whether targeting variability improves renal outcomes.
AIM: To explore the relationship between long-term variabilities in different blood pressure variables and diabetic kidney disease (DKD) in patients with type 2 diabetes. DESIGN: A retrospective study. METHODS: This study included 3050 patients with type 2 diabetes whose metabolic parameters were regularly checked. Intrapersonal means and standard deviations (SDs) of all recorded systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) measurements were calculated. Subjects were divided into four groups: Q1 (SBP-Mean < 130, SBP-SD < 11.06); Q2 (SBP-Mean < 130, SBP-SD ≥ 11.06); Q3 (SBP-Mean ≥ 130, SBP-SD < 11.06); Q4 (SBP-Mean ≥ 130, SBP-SD ≥ 11.06). Similarly, based on whether the PP-Mean was higher or lower than 80 mmHg (average PP-Mean) and the PP-SD was higher or lower than 6.48 mmHg (average PP-SD), the involved patients were redivided into Q1'~ Q4' groups. RESULTS: Adjusted for age, sex and diabetes duration, results revealed that the SBP-Mean, SBP-SD, PP-Mean and PP-SD were risk factors for DKD. Meanwhile, patients in the Q4 group had the highest DKD prevalence (HR = 1.976, p < .001), while Q1 group had the lowest. In addition, patients in the Q3 group (HR = 1.614, P < .001) had a higher risk of DKD than those in the Q2 group (HR = 1.408, P < .001). After re-stratification by PP-Mean and PP-SD, patients in the Q4' group had the highest risk of DKD (HR = 1.370, p < .001), while those in the Q1' group had the lowest risk. Patients in the Q3' group (HR = 1.266, p < .001) had a higher risk of DKD than those in the Q2' group (HR = 1.212, p < .001).
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Xu et al. (2022) conducted a cohort in Type 2 diabetes mellitus (n=3,050). High mean and high variability of systolic blood pressure (SBP-Mean ≥ 130, SBP-SD ≥ 11.06) vs. Low mean and low variability of systolic blood pressure (SBP-Mean < 130, SBP-SD < 11.06) was evaluated on Diabetic kidney disease (DKD) (HR 1.976, p=<0.001). High mean and high variability of systolic blood pressure (SBP-Mean ≥ 130, SBP-SD ≥ 11.06) was associated with the highest risk of diabetic kidney disease (HR 1.976, p < 0.001).
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