Published Online
on August 23, 2004

A more recent version of this article appeared on August 31, 2004

This Article Full Text (PDF) All Versions of this Article: 110/9/1076    most recent 01.CIR.0000139903.29522.8Dv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rönnback, M. Search for Related Content PubMed PubMed Citation Articles by Rönnback, M. Related Collections Other arteriosclerosis Type 1 diabetes

Submitted on October 29, 2003
Revised on April 13, 2004
Accepted on April 14, 2004

Altered Age-Related Blood Pressure Pattern in Type 1 Diabetes

Mats Rönnback MD, Johan Fagerudd MD, DMSc, Carol Forsblom DMSc, Kim Pettersson-Fernholm MD, Antti Reunanen MD, DMSc, Per-Henrik Groop MD, DMSc^*, on behalf of the Finnish Diabetic Nephropathy (FinnDiane) Study Group

From the Folkhälsan Research Center (M.R., J.F., C.F., K.P.-F., P.-H.G.), Biomedicum Helsinki; the Department of Medicine (M.R., J.F., C.F., K.P.-F., P.-H.G.), Division of Nephrology, Helsinki University Central Hospital; and the National Public Health Institute (A.R.), Helsinki, Finland.

^* To whom correspondence should be addressed. E-mail: per-henrik.groop{at}helsinki.fi.

Background--Pulse pressure (PP) increases with age as a result of arterial stiffening and is a powerful predictor of cardiovascular disease. Type 1 diabetes is associated with excessive cardiovascular mortality and increased arterial stiffness. We examined whether the age-related blood pressure changes in type 1 diabetic patients differ from those of the nondiabetic background population.

Methods and Results--We performed a cross-sectional, case-control study of 2988 consecutively selected diabetic subjects and 5486 randomly selected nondiabetic control subjects. Blood pressure was measured twice by mercury sphygmomanometry on a single occasion. Compared with controls, diabetic subjects had a higher systolic blood pressure in all age groups, whereas diastolic blood pressure was higher in those <40 years but lower in those >45 years of age. Consequently, diabetic subjects had a higher PP and a higher prevalence of isolated systolic hypertension. The early age-related rise in PP was more pronounced in subjects with diabetic nephropathy but was also evident in diabetic subjects with normal albumin excretion rate. In a multiple regression analysis, PP in diabetic patients was associated with age, male sex, duration of diabetes, and albuminuria.

Conclusions--A higher systolic pressure and an earlier decrease in diastolic pressure result in a higher and more rapidly increasing PP in type 1 diabetic patients. Our findings indicate accelerated arterial aging, which may contribute to the higher cardiovascular morbidity and mortality in these patients.

Key words: aging • arteriosclerosis • blood pressure • diabetes mellitus • hypertension

This article has been cited by other articles:

				E. Fernandez-Egea, M. Bernardo, C. M. Heaphy, J. K. Griffith, E. Parellada, E. Esmatjes, I. Conget, L. Nguyen, V. George, H. Stoppler, et al. Telomere Length and Pulse Pressure in Newly Diagnosed, Antipsychotic-Naive Patients With Nonaffective Psychosis Schizophr Bull, March 11, 2009; (2009) sbn169v1. [Abstract] [Full Text] [PDF]

				A. Dost, C. Klinkert, T. Kapellen, A. Lemmer, A. Naeke, M. Grabert, J. Kreuder, R. W. Holl, and for the DPV Science Initiative Arterial Hypertension Determined by Ambulatory Blood Pressure Profiles: Contribution to microalbuminuria risk in a multicenter investigation in 2,105 children and adolescents with type 1 diabetes Diabetes Care, April 1, 2008; 31(4): 720 - 725. [Abstract] [Full Text] [PDF]

				J.-C. Philips, M. Marchand, and A. J. Scheen Squatting Amplifies Pulse Pressure Increase With Disease Duration in Patients With Type 1 Diabetes Diabetes Care, February 1, 2008; 31(2): 322 - 324. [Abstract] [Full Text] [PDF]

				E. Osher and N. Stern Diastolic Pressure in Type 2 Diabetes: Can target systolic pressure be reached without "diastolic hypotension"? Diabetes Care, February 1, 2008; 31(Supplement_2): S249 - S254. [Abstract] [Full Text] [PDF]

				R. Sabit, C. E. Bolton, P. H. Edwards, R. J. Pettit, W. D. Evans, C. M. McEniery, I. B. Wilkinson, J. R. Cockcroft, and D. J. Shale Arterial Stiffness and Osteoporosis in Chronic Obstructive Pulmonary Disease Am. J. Respir. Crit. Care Med., June 15, 2007; 175(12): 1259 - 1265. [Abstract] [Full Text] [PDF]

				C. Bouvet, W. Peeters, S. Moreau, D. deBlois, and P. Moreau A new rat model of diabetic macrovascular complication Cardiovasc Res, February 1, 2007; 73(3): 504 - 511. [Abstract] [Full Text] [PDF]

				E. Kimoto, T. Shoji, K. Shinohara, S. Hatsuda, K. Mori, S. Fukumoto, H. Koyama, M. Emoto, Y. Okuno, and Y. Nishizawa Regional Arterial Stiffness in Patients with Type 2 Diabetes and Chronic Kidney Disease J. Am. Soc. Nephrol., August 1, 2006; 17(8): 2245 - 2252. [Abstract] [Full Text] [PDF]

				M. Ronnback, B. Isomaa, J. Fagerudd, C. Forsblom, P.-H. Groop, T. Tuomi, L. Groop, and for the Botnia Study Group Complex Relationship Between Blood Pressure and Mortality in Type 2 Diabetic Patients: A Follow-Up of the Botnia Study Hypertension, February 1, 2006; 47(2): 168 - 173. [Abstract] [Full Text] [PDF]

				J M Gonzalez-Clemente, G Gimenez-Perez, C Richart, M Broch, A Caixas, A Megia, O Gimenez-Palop, I Simon, D Mauricio, and J Vendrell The tumour necrosis factor (TNF)-{alpha} system is activated in accordance with pulse pressure in normotensive subjects with type 1 diabetes mellitus Eur. J. Endocrinol., November 1, 2005; 153(5): 687 - 691. [Abstract] [Full Text] [PDF]

				J. Waden, H. Tikkanen, C. Forsblom, J. Fagerudd, K. Pettersson-Fernholm, T. Lakka, M. Riska, P.-H. Groop, and on behalf of the FinnDiane Study Group Leisure Time Physical Activity Is Associated With Poor Glycemic Control in Type 1 Diabetic Women: The FinnDiane study Diabetes Care, April 1, 2005; 28(4): 777 - 782. [Abstract] [Full Text] [PDF]

				J. Fagerudd, C. Forsblom, K. Pettersson-Fernholm, M. Saraheimo, J. Waden, M. Ronnback, M. Rosengard-Barlund, C.-G. af Bjorkesten, L. Thorn, M. Wessman, et al. Birth Weight Is Inversely Correlated to Adult Systolic Blood Pressure and Pulse Pressure in Type 1 Diabetes Hypertension, December 1, 2004; 44(6): 832 - 837. [Abstract] [Full Text] [PDF]