Dual factor pulse pressure: body mass index and outcome in type 2 diabetic subjects on maintenance hemodialysis. A longitudinal study 2003–2006

Figures & data

Table 1 Characteristics of the type 2 diabetic subjects on chronic maintenance hemodialysis (N = 80)

	All N = 80	Incidence of cardiovascular events or death
		No N = 54	Yes N = 26	P
Quantitative parameters*
Age years	62 (55–70)	61 (53–71)	65 (60–70)	0.28
BMI kg/m^2	26 (23–30)	27 (23–31)	26 (22–29)	0.20
Duration of dialysis (years)	2 (1–4)	2 (1–4.2)	2 (0.5–4)	0.97
SBP mm Hg	151 (141–167)	153 (142–165)	156 (142–169)	0.36
DBP mm Hg	78 (70–86)	77 (70–85)	80 (69–86)	0.92
PP mm Hg	74 (63–87)	73 (62–84)	76 (69–90)	0.12
Qualitative parameters **
Gender (women)	46 (57.5)	34 (63.0)	12 (46.2)	0.15
Duration of dialysis ≥3 years	37 (46.3)	24 (44.4)	13 (50.0)	0.64
High PP	19 (23.8)	10 (18.5)	9 (34.6)	0.11
Hypertension	75 (94)	62 (93)	13 (100)	0.31
Antihypertensive medications	63 (79)	51 (76)	12 (92)	0.19
Absence of obesity	61 (76.3)	38 (70.4)	23 (88.5)	0.07
Morbid obesity	4 (5)	4 (7)	0 (0)	0.15
Dual factor:	17 (21.3)	8 (14.8)	9 (34.6)	0.04
High PP – nonobese
Pre-existing CV events	30 (37.5)	17 (31.5)	13 (50.0)	0.1
Incident CV events	13 (18.3)	–	13 (50.0)	–
Deaths	23 (28.8)	–	23 (88.5)	–

Notes: Data are expressed as: *median (IQR), **number (%). High PP ≥ 75th percentile of the overall PP values for each gender. Morbid obesity: BMI ≥ 40 mm Hg. Hypertension: SBP ≥ 140 or a DBP ≥ 90 mmHg or history of hypertension and current use of antihypertensive medication.

Abbreviations: BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; PP, pulse pressure; CV events, cardiovascular events.

Table 2 Unadjusted hazard ratios for the occurrence of cardiovascular events and deaths in type 2 Diabetic subjects on maintenance hemodialysis (N = 80), Guadeloupe, 2003–2006

	N	Cardiovascular events			Death
		HR	(95% CI)	P	HR	(95% CI)	P
Gender (men)	34	3.2	(0.9–10.4)	0.05	1.5	(0.7–3.4)	0.33
Age (/10 years)	–	0.9	(0.6–1.6)	0.90	1.3	(0.8–1.9)	0.30
Pre-existing CV events	30	2.2	(0.7–6.6)	0.15	2.0	(0.9–4.6)	0.09
HD duration ≥ 3 years	37	1.3	(0.5–4.0)	0.60	1.1	(0.5–2.4)	0.90
Use of antihypertensive medications	63	3.5	(0.5–26.8)	0.22	1.3	(0.5–3.8)	0.63
BMI < 30 mmHg	61	3.9	(0.5–30.6)	0.15	3.6	(0.8–15.3)	0.08
PP ≥ 75th	19	2.9	(0.9–8.7)	0.05	2.4	(1.1–5.5)	0.04
PP ≥ 75th - BMI < 30	17	3.5	(1.2–10.5)	0.02	2.9	(1.2–6.7)	0.01

Abbreviations: HR, hazard ratio; CI, confidence interval; HD, hemodialysis; BMI, body mass index (cutoff: 30 Kg/m²); PP, pulse pressure (cutoff: 75th percentile by gender).

Table 3 Adjusted hazard ratios for the occurrence of cardiovascular events and death in type 2 Diabetic subjects on chronic maintenance hemodialysis (N = 80), Guadeloupe 2003–2006

	N	Cardiovascular events			Death
		HR	(95% CI)	P	HR	(95% CI)	P
Model 1
for PP ≥ 75th	19	2.3	(0.7–7.4)	0.15	2.0	(0.8–4.9)	0.13
Model 2
for BMI < 30	61	1.7	(0.2–16.2)	0.63	3.0	(0.7–14.0)	0.16
Model 3
for PP ≥ 75th	19	2.3	(0.7–7.2)	0.16	1.8	(0.8–4.5)	0.16
for BMI < 30	61	1.6	(0.2–15.3)	0.65	2.8	(0.6–13.1)	0.18
Model 4
for dual PP ≥ 75th – BMI < 30	17	2.7	(0.8–8.3)	0.09	2.4	(1.1–5.9)	0.04

Notes: All the models were adjusted for age, gender, time on dialysis, pre-existing cardiovascular events, use of antihypertensive medications. Model 1: adjusted HR for PP ≥ 75th percentile (according to gender). Model 2: adjusted HR for BMI < 30 Kg/m². Model 3: adjusted HR for PP ≥ 75th percentile and BMI < 30 Kg/m^2. jointly entered in the model. Model 4: adjusted HR for dual variable PP ≥ 75th – BMI < 30 Kg/m².

Abbreviations: HR, hazard ratio; CI, confidence interval; BMI, body mass index (cutoff: 30 Kg/m²); PP, pulse pressure (cutoff: 75th percentile by gender).