Blood Pressure Variables and Cardiovascular Risk: New Findings From ADVANCE
Identifieur interne : 008447 ( Main/Exploration ); précédent : 008446; suivant : 008448Blood Pressure Variables and Cardiovascular Risk: New Findings From ADVANCE
Auteurs : Andre-Pascal Kengne [Australie] ; Sébastien Czernichow [France] ; Rachel Huxley [Australie] ; Diederick Grobbee [Pays-Bas] ; Mark Woodward [États-Unis] ; Bruce Neal [Australie] ; Sophia Zoungas [Australie] ; Mark Cooper [Australie] ; Paul Glasziou [Royaume-Uni] ; Pavel Hamet [Canada] ; Stephen B. Harrap [Australie] ; Giuseppe Mancia [Italie] ; Neil Poulter [Royaume-Uni] ; Bryan Williams [Royaume-Uni] ; John Chalmers [Australie]Source :
- Hypertension : (Dallas, Tex. 1979) [ 0194-911X ] ; 2009.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
The relative importance of various blood pressure indices on cardiovascular risk in people with type 2 diabetes mellitus has not been established. This study compares the strengths of the associations between different baseline blood pressure variables (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure) and the 4.3-year risk of major cardiovascular events in the Action in Diabetes and Vascular Disease: Preterax and Diamicron-Modified Release Controlled Evaluation Study. Mean (SD) age for the 11 140 participants was 65.8 years (6.4 years). During follow-up, 1000 major cardiovascular events, 559 major coronary events, and 468 cardiovascular deaths were recorded. After adjustment for age, sex, and treatment allocation, the hazard ratios (95% CIs) associated with 1 increment in SD for the risk of major cardiovascular events were 1.17 (1.10 to 1.24) for SBP; 1.20 (1.13 to 1.28) for PP; 1.12 (1.05 to 1.19) for mean arterial pressure; and 1.04 (0.98 to 1.11) for DBP. The areas under the receiver operating characteristic curve were slightly higher for SBP and PP compared with mean arterial pressure and DBP for major cardiovascular and coronary events. Using achieved instead of baseline blood pressure values marginally improved the effect estimates for SBP, DBP, and mean arterial pressure, with no significant differences in the areas under the receiver operating characteristic curve between models with SBP and those with PP. In conclusion, SBP and PP are the 2 best and DBP is the least effective determinant of the risk of major cardiovascular outcomes in the relatively old patients with type 2 diabetes mellitus participating in the Action in Diabetes and Vascular Disease: Preterax and Diamicron-Modified Release Controlled Evaluation Study. However, SBP may be the simplest and most useful predictor across a wider range of age groups and populations.
Affiliations:
- Australie, Canada, France, Italie, Pays-Bas, Royaume-Uni, États-Unis
- Angleterre, Grand Londres, Lombardie, Nouvelle-Galles du Sud, Oxfordshire, Utrecht (province), Île-de-France
- Londres, Milan, Oxford, Paris, Sydney, Utrecht
- Université d'Oxford, Université de Sydney
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Hospital</s1><s2>London</s2><s3>GBR</s3><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Williams, Bryan" sort="Williams, Bryan" uniqKey="Williams B" first="Bryan" last="Williams">Bryan Williams</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Department of Cardiovascular Sciences University of Leicester</s1><s2>Leicester</s2><s3>GBR</s3><sZ>14 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Department of Cardiovascular Sciences University of Leicester</wicri:noRegion></affiliation></author><author><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>George Institute for International Health University of 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last="Czernichow">Sébastien Czernichow</name><affiliation wicri:level="3"><inist:fA14 i1="02"><s1>Department of Public Health Avicenne Hospital, University of Paris 13</s1><s2>Paris</s2><s3>FRA</s3><sZ>2 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="Huxley, Rachel" sort="Huxley, Rachel" uniqKey="Huxley R" first="Rachel" last="Huxley">Rachel Huxley</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>George Institute for International Health University of Sydney</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Grobbee, Diederick" sort="Grobbee, Diederick" uniqKey="Grobbee D" first="Diederick" last="Grobbee">Diederick Grobbee</name><affiliation wicri:level="3"><inist:fA14 i1="03"><s1>Julius Centre for Health Sciences and Primary Care University Medical Centre Utrecht</s1><s2>Utrecht</s2><s3>NLD</s3><sZ>4 aut.</sZ></inist:fA14><country>Pays-Bas</country><placeName><settlement type="city">Utrecht</settlement><region nuts="2" type="province">Utrecht (province)</region></placeName></affiliation></author><author><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Mount Sinai School of Medicine</s1><s2>New York, NY</s2><s3>USA</s3><sZ>5 aut.</sZ></inist:fA14><country>États-Unis</country><wicri:noRegion>Mount Sinai School of Medicine</wicri:noRegion></affiliation></author><author><name sortKey="Neal, Bruce" sort="Neal, Bruce" uniqKey="Neal B" first="Bruce" last="Neal">Bruce Neal</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>George Institute for International Health University of Sydney</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author><author><name sortKey="Zoungas, Sophia" sort="Zoungas, Sophia" uniqKey="Zoungas S" first="Sophia" last="Zoungas">Sophia Zoungas</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Monash University</s1><s2>Melbourne, Victoria</s2><s3>AUS</s3><sZ>7 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Monash University</wicri:noRegion></affiliation></author><author><name sortKey="Cooper, Mark" sort="Cooper, Mark" uniqKey="Cooper M" first="Mark" last="Cooper">Mark Cooper</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Baker IDI Heart Research Institute</s1><s2>Melbourne, Victoria</s2><s3>AUS</s3><sZ>8 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Baker IDI Heart Research Institute</wicri:noRegion></affiliation></author><author><name sortKey="Glasziou, Paul" sort="Glasziou, Paul" uniqKey="Glasziou P" first="Paul" last="Glasziou">Paul Glasziou</name><affiliation wicri:level="4"><inist:fA14 i1="07"><s1>Centre for Evidence-Based Medicine Department of Primary Health Care, University of Oxford</s1><s2>Oxford</s2><s3>GBR</s3><sZ>9 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Oxford</settlement><region type="country">Angleterre</region><region type="comté" nuts="2">Oxfordshire</region><settlement type="city">Oxford</settlement></placeName><orgName type="university">Université d'Oxford</orgName></affiliation></author><author><name sortKey="Hamet, Pavel" sort="Hamet, Pavel" uniqKey="Hamet P" first="Pavel" last="Hamet">Pavel Hamet</name><affiliation wicri:level="1"><inist:fA14 i1="08"><s1>Centre Hospitalier de l'Université de Montréal Université de Montréal</s1><s2>Montreal, Quebec</s2><s3>CAN</s3><sZ>10 aut.</sZ></inist:fA14><country>Canada</country><wicri:noRegion>Centre Hospitalier de l'Université de Montréal Université de Montréal</wicri:noRegion></affiliation></author><author><name sortKey="Harrap, Stephen B" sort="Harrap, Stephen B" uniqKey="Harrap S" first="Stephen B." last="Harrap">Stephen B. Harrap</name><affiliation wicri:level="1"><inist:fA14 i1="09"><s1>Department of Physiology niversity of Melbourne</s1><s2>Melbourne, Victoria</s2><s3>AUS</s3><sZ>11 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Department of Physiology niversity of Melbourne</wicri:noRegion></affiliation></author><author><name sortKey="Mancia, Giuseppe" sort="Mancia, Giuseppe" uniqKey="Mancia G" first="Giuseppe" last="Mancia">Giuseppe Mancia</name><affiliation wicri:level="3"><inist:fA14 i1="10"><s1>University of Milan-Biocca and San Gerardo Hospital</s1><s2>Milan</s2><s3>ITA</s3><sZ>12 aut.</sZ></inist:fA14><country>Italie</country><placeName><settlement type="city">Milan</settlement><region nuts="2">Lombardie</region></placeName></affiliation></author><author><name sortKey="Poulter, Neil" sort="Poulter, Neil" uniqKey="Poulter N" first="Neil" last="Poulter">Neil Poulter</name><affiliation wicri:level="3"><inist:fA14 i1="11"><s1>Imperial College and St Mary's Hospital</s1><s2>London</s2><s3>GBR</s3><sZ>13 aut.</sZ></inist:fA14><country>Royaume-Uni</country><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Williams, Bryan" sort="Williams, Bryan" uniqKey="Williams B" first="Bryan" last="Williams">Bryan Williams</name><affiliation wicri:level="1"><inist:fA14 i1="12"><s1>Department of Cardiovascular Sciences University of Leicester</s1><s2>Leicester</s2><s3>GBR</s3><sZ>14 aut.</sZ></inist:fA14><country>Royaume-Uni</country><wicri:noRegion>Department of Cardiovascular Sciences University of Leicester</wicri:noRegion></affiliation></author><author><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><affiliation wicri:level="4"><inist:fA14 i1="01"><s1>George Institute for International Health University of Sydney</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>1 aut.</sZ><sZ>3 aut.</sZ><sZ>6 aut.</sZ><sZ>15 aut.</sZ></inist:fA14><country>Australie</country><placeName><settlement type="city">Sydney</settlement><region type="état">Nouvelle-Galles du Sud</region></placeName><orgName type="university">Université de Sydney</orgName></affiliation></author></analytic><series><title level="j" type="main">Hypertension : (Dallas, Tex. 1979)</title><title level="j" type="abbreviated">Hypertension : (Dallas Tex., 1979)</title><idno type="ISSN">0194-911X</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Hypertension : (Dallas, Tex. 1979)</title><title level="j" type="abbreviated">Hypertension : (Dallas Tex., 1979)</title><idno type="ISSN">0194-911X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Arterial pressure</term><term>Blood pressure</term><term>Cardiovascular disease</term><term>Hypertension</term><term>Risk factor</term><term>Type 2 diabetes</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Diabète de type 2</term><term>Pression artérielle</term><term>Pression sanguine</term><term>Facteur risque</term><term>Pathologie de l'appareil circulatoire</term><term>Hypertension artérielle</term><term>Maladie cardiovasculaire</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The relative importance of various blood pressure indices on cardiovascular risk in people with type 2 diabetes mellitus has not been established. This study compares the strengths of the associations between different baseline blood pressure variables (systolic blood pressure [SBP], diastolic blood pressure [DBP], pulse pressure [PP], and mean arterial pressure) and the 4.3-year risk of major cardiovascular events in the Action in Diabetes and Vascular Disease: Preterax and Diamicron-Modified Release Controlled Evaluation Study. Mean (SD) age for the 11 140 participants was 65.8 years (6.4 years). During follow-up, 1000 major cardiovascular events, 559 major coronary events, and 468 cardiovascular deaths were recorded. After adjustment for age, sex, and treatment allocation, the hazard ratios (95% CIs) associated with 1 increment in SD for the risk of major cardiovascular events were 1.17 (1.10 to 1.24) for SBP; 1.20 (1.13 to 1.28) for PP; 1.12 (1.05 to 1.19) for mean arterial pressure; and 1.04 (0.98 to 1.11) for DBP. The areas under the receiver operating characteristic curve were slightly higher for SBP and PP compared with mean arterial pressure and DBP for major cardiovascular and coronary events. Using achieved instead of baseline blood pressure values marginally improved the effect estimates for SBP, DBP, and mean arterial pressure, with no significant differences in the areas under the receiver operating characteristic curve between models with SBP and those with PP. In conclusion, SBP and PP are the 2 best and DBP is the least effective determinant of the risk of major cardiovascular outcomes in the relatively old patients with type 2 diabetes mellitus participating in the Action in Diabetes and Vascular Disease: Preterax and Diamicron-Modified Release Controlled Evaluation Study. However, SBP may be the simplest and most useful predictor across a wider range of age groups and populations.</div></front></TEI><affiliations><list><country><li>Australie</li><li>Canada</li><li>France</li><li>Italie</li><li>Pays-Bas</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Lombardie</li><li>Nouvelle-Galles du Sud</li><li>Oxfordshire</li><li>Utrecht (province)</li><li>Île-de-France</li></region><settlement><li>Londres</li><li>Milan</li><li>Oxford</li><li>Paris</li><li>Sydney</li><li>Utrecht</li></settlement><orgName><li>Université d'Oxford</li><li>Université de Sydney</li></orgName></list><tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Kengne, Andre Pascal" sort="Kengne, Andre Pascal" uniqKey="Kengne A" first="Andre-Pascal" last="Kengne">Andre-Pascal Kengne</name></region><name sortKey="Chalmers, John" sort="Chalmers, John" uniqKey="Chalmers J" first="John" last="Chalmers">John Chalmers</name><name sortKey="Cooper, Mark" sort="Cooper, Mark" uniqKey="Cooper M" first="Mark" last="Cooper">Mark Cooper</name><name sortKey="Harrap, Stephen B" sort="Harrap, Stephen B" uniqKey="Harrap S" first="Stephen B." last="Harrap">Stephen B. Harrap</name><name sortKey="Huxley, Rachel" sort="Huxley, Rachel" uniqKey="Huxley R" first="Rachel" last="Huxley">Rachel Huxley</name><name sortKey="Neal, Bruce" sort="Neal, Bruce" uniqKey="Neal B" first="Bruce" last="Neal">Bruce Neal</name><name sortKey="Zoungas, Sophia" sort="Zoungas, Sophia" uniqKey="Zoungas S" first="Sophia" last="Zoungas">Sophia Zoungas</name></country><country name="France"><region name="Île-de-France"><name sortKey="Czernichow, Sebastien" sort="Czernichow, Sebastien" uniqKey="Czernichow S" first="Sébastien" last="Czernichow">Sébastien Czernichow</name></region></country><country name="Pays-Bas"><region name="Utrecht (province)"><name sortKey="Grobbee, Diederick" sort="Grobbee, Diederick" uniqKey="Grobbee D" first="Diederick" last="Grobbee">Diederick Grobbee</name></region></country><country name="États-Unis"><noRegion><name sortKey="Woodward, Mark" sort="Woodward, Mark" uniqKey="Woodward M" first="Mark" last="Woodward">Mark Woodward</name></noRegion></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Glasziou, Paul" sort="Glasziou, Paul" uniqKey="Glasziou P" first="Paul" last="Glasziou">Paul Glasziou</name></region><name sortKey="Poulter, Neil" sort="Poulter, Neil" uniqKey="Poulter N" first="Neil" last="Poulter">Neil Poulter</name><name sortKey="Williams, Bryan" sort="Williams, Bryan" uniqKey="Williams B" first="Bryan" last="Williams">Bryan Williams</name></country><country name="Canada"><noRegion><name sortKey="Hamet, Pavel" sort="Hamet, Pavel" uniqKey="Hamet P" first="Pavel" last="Hamet">Pavel Hamet</name></noRegion></country><country name="Italie"><region name="Lombardie"><name sortKey="Mancia, Giuseppe" sort="Mancia, Giuseppe" uniqKey="Mancia G" first="Giuseppe" last="Mancia">Giuseppe Mancia</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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