Pulse Pressure Predicts Incident Cardiovascular Disease but Not Diabetic Nephropathy in Patients With Type 1 Diabetes (The FinnDiane Study)

  1. for the FinnDiane Study Group*
  1. 1Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland
  2. 2Division of Nephrology, Department of Medicine, Helsinki University Central Hospital, Finland
  3. 3The Baker IDI Heart and Diabetes Institute, Melbourne, Australia
  1. Corresponding author: Per-Henrik Groop, per-henrik.groop{at}helsinki.fi.

Abstract

OBJECTIVE Pulse pressure (PP), an estimate of arterial stiffness, has been shown to be associated with incident cardiovascular disease (CVD) in patients with type 1 diabetes (T1D). However, diabetic kidney disease, a strong predictor of CVD, was not previously taken into account. Furthermore, the role of PP as a predictor of diabetic nephropathy is not known. Therefore, we prospectively investigated the associations between PP and these diabetic complications in patients with T1D.

RESEARCH DESIGN AND METHODS A total of 4,509 patients from the FinnDiane Study participated. Follow-up data on incident CVD events and renal status (median 5.3 years) were available in 69 and 76% of the patients, respectively. Altogether, 269 patients (8.6%) had an incident CVD event and 370 patients (10.8%) progressed to a higher level of albuminuria or to end-stage renal disease.

RESULTS PP was higher at baseline in patients who experienced a CVD event (66 ± 18 vs. 52 ± 14 mmHg; P < 0.001) or progressed in their renal status (58 ± 18 vs. 54 ± 15 mmHg; P < 0.01) during follow-up. In a Cox regression model, PP was independently associated with a first ever CVD event (hazard ratio per 10 mmHg 1.22 [95% CI 1.10–1.34]) but not progression of renal disease (1.00 [0.89–1.12]) after adjustments for traditional risk factors.

CONCLUSIONS PP, a marker of arterial stiffness, is a risk factor for cardiovascular complications but not for diabetic nephropathy in patients with T1D.

Footnotes

  • * A complete list of the members of the FinnDiane Study Group can be found in the Supplementary Data.

  • Received October 25, 2010.
  • Accepted January 13, 2011.

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  1. Diabetes Care
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