Abstract 13558: Which Cutoff Value of Clinic BP Better Stratify Cardiovascular Risk in Patinets with Type 2 Diabetes ? - the J-HOP Study -
Introduction: In the JNC-8 guideline, target clinic BP in type 2 diabetes (T2DM) was raised to 140/90mmHg based on recent clinical trials. However, there are still some opinions that the cutoff value of clinic BP 130/80mmHg might be better than 140/90.
Hypothesis: We sought to clarify the hypothesis that different clinic BP cutoff values, 130/80mmHg or 140/90mmHg, could have different impact on cardiovascular risk stratification in patients with T2DM.
Methods: We enrolled 4326 patients who have at least one cardiovascular risk factor, and performed clinic BP monitoring and measured urinary albumin creatinine ratio (UACR) as a surrogate marker of cardiovascular risk. Patients were stratified by 4 groups using SBP 140mmHg and DBP 90 mmHg: Group1, SBP>140,DBP>90; Group2, >140,≤90; Group3; ≤140,>90; Group4; ≤140≤90. Alternatively, SBP 130mmHg and DBP 80mmHg were also used as a cutoff value. Multivariable logistic regression analyses adjusting for age, sex, BMI, history of hypertension, and renal dysfunction were used for the likelihood of microalbuminuria (UACR ≧30mg/g·cr).
Results: The mean age was 64.9±10.9 years; 47.0% were male; and 87.1% had hypertension. There were 1057 (24.5%) patients with T2DM, and they were analyzed in this study. In the cutoff value of SBP 140mmHg and DBP 90 mmHg, the odds ratio (OR) for microalbuminuria was 1.5 to 4 times in higher SBP and/or DBP groups (Figure-left panel). On the other hand, for the cutoff value of SBP 130mmHg and DBP 80 mmHg, OR was 1.6-1.7 in the group with SBP>130mmHg but the likelihood of microalbuminuria was similar between the Group 3 and 4. (Figure-right panel).
Conclusions: In a large cohort sample of T2DM, the cutoff value of clinic BP would be better for 140/90 mmHg than 130/80mmHg with regard to the prediction of microalbuminuria.
Author Disclosures: K. Eguchi: None. S. Hoshide: None. S. Nagasaka: None. K. Kario: None.
- © 2014 by American Heart Association, Inc.