Higher brachial pulse pressure (3rd vs 1st tertile) was significantly associated with an increased risk of diabetic retinopathy (OR 4.59) and diabetic nephropathy (OR 3.0) in patients with type 2 diabetes, whereas central pulse pressure showed no such associations.
Cross-Sectional (n=201)
No
Are central and brachial blood pressures differentially associated with carotid atherosclerosis and microvascular complications in patients with type 2 diabetes?
In patients with type 2 diabetes, brachial pulse pressure is more strongly associated with microvascular complications, while central pulse pressure correlates better with surrogate markers of macrovascular disease.
Effect estimate: OR 4.59 (95% CI 1.72-12.27)
p-value: p=0.002
BACKGROUND: We examined the relationship between central blood pressure (BP), brachial BP with carotid atherosclerosis and microvascular complications in type 2 diabetes mellitus (T2DM). METHODS: We recruited 201 patients who were evaluated for central BP, brachial BP, carotid ultrasonography, brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and microvascular complications. Central BP were calculated using a radial automated tonometric system. RESULTS: Agreement between central BP and brachial BP was very strong (concordance correlation coefficient between central and brachial SBP = 0.889, between central and brachial PP = 0.816). Central pulse pressure (PP) was correlated with mean carotid intima-media thickness (CIMT), baPWV and ABI, whereas brachial PP was borderline significantly correlated with CIMT. The prevalence of nephropathy(DN) and retinopathy(DR) according to the brachial PP tertiles increased, the prevalences of microvascular complications were not different across central PP tertiles. In multivariate analysis, the relative risks (RRs) for the presence of DR were 1.2 and 4.6 for the brachial PP tertiles 2 and 3 when compared with the first tertile. Also, the RRs for the presence of DN were 1.02 and 3 for the brachial PP tertiles 2 and 3 when compared with the first tertile. CONCLUSIONS: Agreement of central BP and brachial BP was very strong. Nonetheless, this study showed that higher brachial PP levels are associated with increased probability for the presence of microvascular complications such as DR/DN. However, there are no associations with central SBP and central PP with microvascular complications. Central BP levels than brachial BP are correlated with surrogate marker of macrovascular complications.
Jung et al. (Thu,) conducted a cross-sectional in Type 2 diabetes mellitus (n=201). Brachial pulse pressure (3rd tertile) vs. Brachial pulse pressure (1st tertile) was evaluated on Presence of diabetic retinopathy (OR 4.59, 95% CI 1.72-12.27, p=0.002). Higher brachial pulse pressure (3rd vs 1st tertile) was significantly associated with an increased risk of diabetic retinopathy (OR 4.59) and diabetic nephropathy (OR 3.0) in patients with type 2 diabetes, whereas central pulse pressure showed no such associations.