Effects of different blood pressures and their long-term variability on the development of diabetic kidney disease in patients with type 2 diabetes mellitus

ABSTRACT

Aim

To explore the relationship between long-term variabilities in different blood pressure variables and diabetic kidney disease (DKD) in patients with type 2 diabetes.

Design

A retrospective study.

Methods

This study included 3050 patients with type 2 diabetes whose metabolic parameters were regularly checked. Intrapersonal means and standard deviations (SDs) of all recorded systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) measurements were calculated. Subjects were divided into four groups: Q1 (SBP-Mean < 130, SBP-SD < 11.06); Q2 (SBP-Mean < 130, SBP-SD ≥ 11.06); Q3 (SBP-Mean ≥ 130, SBP-SD < 11.06); Q4 (SBP-Mean ≥ 130, SBP-SD ≥ 11.06). Similarly, based on whether the PP-Mean was higher or lower than 80 mmHg (average PP-Mean) and the PP-SD was higher or lower than 6.48 mmHg (average PP-SD), the involved patients were redivided into Q1’~ Q4’ groups.

Results

Adjusted for age, sex and diabetes duration, results revealed that the SBP-Mean, SBP-SD, PP-Mean and PP-SD were risk factors for DKD. Meanwhile, patients in the Q4 group had the highest DKD prevalence (HR = 1.976, p < .001), while Q1 group had the lowest. In addition, patients in the Q3 group (HR = 1.614, P < .001) had a higher risk of DKD than those in the Q2 group (HR = 1.408, P < .001). After re-stratification by PP-Mean and PP-SD, patients in the Q4’ group had the highest risk of DKD (HR = 1.370, p < .001), while those in the Q1’ group had the lowest risk. Patients in the Q3’ group (HR = 1.266, p < .001) had a higher risk of DKD than those in the Q2’ group (HR = 1.212, p < .001).

KEYWORDS:

• Diabetic kidney disease
• blood pressure variability
• SBP
• PP
• type 2 diabetes

Acknowledgments

The authors sincerely thank all participants for their time and effort in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

The data used to support the findings of this study are available from the corresponding author upon request.

Consent

Informed consent was obtained from all patients for being included in the study.

Ethical approval

All procedures are in accordance with the ethical standards of the Commission for Responsible Human Experimentation (institutional and national) and in accordance with the Helsinki Declaration of 1975 (revised in 2008).

Additional information

Funding

This study was supported by National key R&D program of China（2021YFE0204800）and Jiangsu Province of Cadres Health (BJ18031).