Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comparative Study
. 2020 Oct 19;19(1):181.
doi: 10.1186/s12933-020-01156-8.

Blood pressure levels and cardiovascular risk according to age in patients with diabetes mellitus: a nationwide population-based cohort study

Hack-Lyoung Kim  1 , Hyue Mee Kim  2 , Chang Hee Kwon  3 , Jeong-Hun Shin  4 , Mi-Hyang Jung  5 , Chan Joo Lee  6 , Dae-Hee Kim  7 , Woo-Hyeun Kim  8 , Si-Hyuck Kang  9 , Ju-Hee Lee  10 , In Jeong Cho  11 , Iksung Cho  6 , Jun Hyeok Lee  12 , Dae Ryong Kang  12 , Hae-Young Lee  13 , Wook-Jin Chung  14 , Sang-Hyun Ihm  15 , Kwang Il Kim  9 , Eun Joo Cho  16 , Il-Suk Sohn  17 , Hyeon-Chang Kim  6 , Jinho Shin  4 , Ju Han Kim  18 , Sung Kee Ryu  19 , Seok-Min Kang  6 , Wook Bum Pyun  11 , Myeong-Chan Cho  10 , Sungha Park  20 , Ki-Chul Sung  21
Affiliations
Comparative Study

Blood pressure levels and cardiovascular risk according to age in patients with diabetes mellitus: a nationwide population-based cohort study

Hack-Lyoung Kim et al. Cardiovasc Diabetol. .

Abstract

Background: Little is known about age-specific target blood pressure (BP) in hypertensive patients with diabetes mellitus (DM). The aim of this study was to determine the BP level at the lowest cardiovascular risk of hypertensive patients with DM according to age.

Methods: Using the Korean National Health Insurance Service database, we analyzed patients without cardiovascular disease diagnosed with both hypertension and DM from January 2002 to December 2011. Primary end-point was composite cardiovascular events including cardiovascular death, myocardial infarction and stroke.

Results: Of 241,148 study patients, 35,396 had cardiovascular events during a median follow-up period of 10 years. At the age of < 70 years, the risk of cardiovascular events was lower in patients with BP < 120/70 mmHg than in those with BP 130-139/80-89 mmHg. At the age of ≥ 70, however, there were no significant differences in the risk of cardiovascular events between patients with BP 130-139/80-89 mmHg and BP < 120/70 mmHg. The risk of cardiovascular events was similar between patients with BP 130-139/80-89 mmHg and BP 120-129/70-79 mmHg, and it was significantly higher in those with BP ≥ 140/90 mmHg than in those with BP 130-139/80-89 mmHg at all ages.

Conclusions: In a cohort of hypertensive patients who had DM but no history of cardiovascular disease, lower BP was associated with lower risk of cardiovascular events especially at the age of < 70. However, low BP < 130-139/80-89 mmHg was not associated with decreased cardiovascular risk, it may be better to keep the BP of 130-139/80-89 mmHg at the age of ≥ 70.

Keywords: Age; Cardiovascular risk; Diabetes mellitus; Hypertension; Target blood pressure.

PubMed Disclaimer

Conflict of interest statement

All authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Study flowchart showing patient enrollment
Fig. 2
Fig. 2
Adjusted hazard ratio for the risk of cardiovascular events according to blood pressure and age categories
Fig. 3
Fig. 3
Restricted cubic spline curves showing age-specific adjusted hazard ratios for the risk of cardiovascular events according to SBP and DBP categories. Solid lines indicate hazard ratios and shaded areas indicate 95% confidence intervals. SBP, systolic blood pressure; DBP, diastolic blood pressure
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Worldwide trends in blood pressure from 1975 to 2015: a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. Lancet. 2017;389:37–55. - PMC - PubMed
    1. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388:1545–1602. - PMC - PubMed
    1. Lawes CM, Vander Hoorn S, Rodgers A. Global burden of blood-pressure-related disease, 2001. Lancet. 2008;371:1513–1518. doi: 10.1016/S0140-6736(08)60655-8. - DOI - PubMed
    1. Flint AC, Conell C, Ren X, et al. Effect of systolic and diastolic blood pressure on cardiovascular outcomes. N Engl J Med. 2019;381:243–251. doi: 10.1056/NEJMoa1803180. - DOI - PubMed
    1. Laing SP, Swerdlow AJ, Slater SD, et al. Mortality from heart disease in a cohort of 23,000 patients with insulin-treated diabetes. Diabetologia. 2003;46:760–765. doi: 10.1007/s00125-003-1116-6. - DOI - PubMed

Publication types

MeSH terms