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Home-measured pulse pressure is a predictor of cardiovascular disease in type 2 diabetes: The KAMOGAWA-HBP study
Affiliation:1. Department of Endocrinology and Metabolism, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan;2. Department of Endocrinology and Metabolism, Kyoto Second Red Cross Hospital, Kyoto, Japan;3. Department of Endocrinology and Metabolism, Kyoto First Red Cross Hospital, Kyoto, Japan;4. Department of Endocrinology and Metabolism, Osaka General Hospital of West Japan Railway Company, Osaka, Japan;5. Department of Cardiology, Nishijin Hospital, Kyoto, Japan;6. Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Hokkaido, Japan;7. Department of Organ Transplantation and General Surgery, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
Abstract:Background and aimsPulse pressure (PP) is a prognostic predictor of cardiovascular mortality. This retrospective cohort study aimed to investigate the association between home PP measurements and cardiovascular disease in patients with type 2 diabetes.Methods and resultsHome blood pressure was measured for 14 consecutive days in 1082 patients with type 2 diabetes, and pulse pressure was calculated.A 10 mmHg increase in morning PP was associated with a 1.30-fold increase in the risk of cardiovascular disease. The risk of cardiovascular disease was 1.88 times higher in the morning in the higher PP group than in the lower PP group. In the receiver operating characteristic analysis, the areas under the curve (95% confidence interval) corresponding to the PP (morning, evening, and clinic) for new-onset cardiovascular disease were 0.63 (0.58–0.69), 0.62 (0.57–0.67), and 0.59 (0.54–0.64), respectively. The area under the curve for PP measured in the morning was significantly greater than that for PP measured in the clinic (P = 0.032).ConclusionHome-measured PP is a better predictor of new-onset cardiovascular disease than clinic-measured PP, in patients with type 2 diabetes.
Keywords:Cardiovascular disease  Home blood pressure monitoring  Pulse pressure  Retrospective cohort study  Type 2 diabetes
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