Cardiovascular outcomes at recommended blood pressure targets in middle-aged and elderly patients with type 2 diabetes mellitus and hypertension

Figures & data

Table 1. Baseline characteristics of the 4 groups of diabetic patients in which treatment reduced BP below 140/90 mmHg for different proportions (from < 25% to ≥ 75%) of the overall duration of treatment.

	< 25%	25%–49%	50%–74%	≥ 75%	P (trend)
N	1688	946	1042	1574
Females (%)	47.0	46.7	42.7	40.7	<0.0001
Age (years)	67.6 ± 7.7	68.0 ± 8.0	67.0 ± 7.8	66.1 ± 8.0	<0.0001
Caucasians (%)	89.2	87.4	86.2	81.2	<0.0001
SBP (mmHg)	166.0 ± 17.6	158.0 ± 17.0	153.0 ± 16.7	146.0 ± 17.1	<0.0001
DBP (mmHg)	88.8 ± 10.9	87.1 ± 10.6	86.6 ± 10.6	85.0 ± 10.4	<0.0001
Heart rate (beats/min)°	73.0 ± 13.8	72.7 ± 13.6	72.5 ± 13.8	72.3 ± 13.7	0.523
Antihypertensive treatment (%)	93.9	93.3	93.7	94.2	0.728
Body mass index (kg/m^2)	30.1 ± 5.4	30.1 ± 5.3	29.9 ± 5.6	29.7 ± 5.5	0.088
Smoking (%)	17.5	19.0	19.6	24.7	<0.0001
Proteinuria (%)	32.8	28.8	26.1	24.0	<0.0001
High serum creatinine (%)	4.9	5.3	3.2	1.9	<0.0001
High total cholesterol (%)	32.6	29.0	28.9	25.0	<0.0001
Left ventricular hypertrophy (%)*	7.5	5.5	4.4	3.1	<0.0001
Coronary disease (%)	35.7	38.7	39.6	45.6	<0.0001
Stroke / TIA (%)	15.0	17.1	17.7	15.7	0.508
Peripheral artery disease (%)	13.7	14.3	11.2	10.0	<0.0003
On-treatment mean SBP (mmHg)	156.2 ± 11.0	143.4 ± 4.0	137.9 ± 3.7	131.0 ± 5.6	<0.0001
On-treatment mean DBP (mmHg)	84.2 ± 8.3	80.4 ± 6.5	79.4 ± 5.9	77.5 ± 5.6	<0.0001

Data are shown as means ± SD or %. °by ECG; * ECG, strain pattern; Data from all randomised patients without GCP deficiencies and missing BP values; S: systolic; D: diastolic; TIA: transient ischaemic attack; High serum creatinine: ≥ 150 µmol/L; High total cholesterol: ≥ 6 mmol/L (240 mg/dL).

Figure 1. Incidence of morbid and fatal events in groups of diabetic patients divided according to the proportion of the overall treatment duration (< 25% to ≥ 75%) in which BP was reduced < 140/90 mmHg (upper panel) or < 130/80 mmHg (lower panel) prior to the occurrence of an event. n refers to the number of patients in each group. BP: blood pressure; CV: cardiovascular; MI: myocardial infarction; CHF: congestive heart failure.

Figure 2. Percent (and 95% CI) change in the risk of events according to the proportion of time in which BP was reduced < 140/90 mmHg (upper panel) or < 130/80 mmHg (lower panel) in groups of diabetic patients. The group in which these BP targets were achieved for ≥ 75% of the time is used as reference and shown by the empty circle (minor variations in ‘n’ as some endpoints were composite and primary and other endpoints secondary). Data were adjusted for both baseline covariates and achieved average systolic BP and diastolic BP. P values refer to trend. NS: not significant. Other symbols as in Figure 1.

Table 2. Baseline characteristics of the 4 groups of diabetic patients in which treatment reduced BP below 130/80 mmHg for different proportions (from < 25% to ≥ 75%) of the overall duration of treatment.

	< 25%	25%–49%	50%–74%	≥ 75%	P (trend)
n	4348	516	245	141
Females (%)	44.8	40.7	43.3	35.5	0.017
Age (years)	67.2 ± 7.9	66.8 ± 8.0	66.7 ± 7.7	66.8 ± 8.4	0.57
Caucasians (%)	86.8	82.0	83.7	74.5	<0.0001
SBP (mmHg)	159.0 ± 18.0	147.0 ± 16.9	143.0 ± 17.7	134.0 ± 16.6	<0.0001
DBP (mmHg)	88.0 ± 10.5	83.0 ± 10.6	81.6 ± 10.8	77.8 ± 11.0	<0.0001
Heart rate (beats/min)°	72.8 ± 13.7	71.8 ± 13.8	72.4 ± 13.6	71.3 ± 13.3	0.25
Antihypertensive treatment (%)	93.3	96.1	95.9	97.9	0.0005
Body mass index (kg/m^2)	29.9 ± 5.4	30.0 ± 5.8	30.2 ± 5.8	29.5 ± 5.7	0.67
Smoking (%)	20.2	20.0	22.9	22.0	0.49
Proteinuria (%)	28.8	27.1	21.2	23.4	0.014
High serum creatinine (%)	4.0	3.5	0.4	2.8	0.029
High total cholesterol (%)	30.2	25.2	20.8	19.1	<0.0001
Left ventricular hypertrophy (%)*	5.3	5.0	4.9	3.5	0.49
Coronary disease (%)	37.6	47.9	52.7	60.3	<0.0001
Stroke / TIA (%)	15.7	19.2	15.9	17.7	0.096
Peripheral artery disease (%)	12.3	11.8	11.4	12.8	0.74
On-treatment mean SBP (mmHg)	145.7 ± 11.7	132.0 ± 4.1	127.0 ± 3.6	120.5 ± 5.3	<0.0001
On-treatment mean DBP (mmHg)	81.9 ± 7.1	75.8 ± 5.2	73.8 ± 4.6	70.6 ± 5.0	<0.0001

Symbols and explanations as in Table 1.

Data availability statement

The data that support the findings of this study are available from the corresponding author, S.E.K. upon dire need.