Pulse Pressure Predicts Incident Cardiovascular Disease but Not Diabetic Nephropathy in Patients With Type 1 Diabetes (The FinnDiane Study)
Article Figures & Tables
Figures
- Figure 1
A: Age-adjusted survival curves for an incident CVD event (coronary event, stroke, peripheral vascular event) by quartiles of PP. B: Age-adjusted survival curves for any progression in renal status (defined as any increase in albuminuria level or progression to ESRD) by quartiles of PP.
Tables
- Table 1
Patient characteristics according to baseline quartiles of pulse pressure
1st 2nd 3rd 4th P value Age-corrected P value Patients (N) 1,145 1,080 1,137 1,147 — — Sex (% women) 42 50 58 56 <0.001 <0.001 Age (years) 33 ± 9 36 ± 10 39 ± 12 47 ± 12 <0.001 — Duration (years) 17 ± 9 19 ± 11 22 ± 12 30 ± 12 <0.001 <0.001 Age at onset (years) 16 ± 11 17 ± 11 17 ± 11 17 ± 11 0.25 <0.001 BMI (kg/m2) 24.6 ± 3.7 24.8 ± 3.8 25.2 ± 3.5 25.5 ± 3.7 <0.001 0.025 HbA1c (%) 8.5 ± 1.7 8.4 ± 1.5 8.4 ± 1.4 8.5 ± 1.5 0.16 0.022 Total cholesterol (mmol/L) 4.9 ± 1.0 4.9 ± 1.0 4.9 ± 1.0 5.2 ± 1.1 <0.001 <0.001 HDL cholesterol (mmol/L) 1.6 ± 0.5 1.6 ± 0.5 1.6 ± 0.6 1.6 ± 0.5 0.49 0.073 LDL cholesterol (mmol/L) 3.0 ± 0.8 3.0 ± 1.1 3.0 ± 0.9 3.2 ± 0.9 <0.001 0.159 Triacylglycerol (mmol/L) 1.02 (0.77–1.43) 1.00 (0.75–1.41) 1.04 (0.77–1.46) 1.10 (0.81–1.58) 0.03 <0.001 Insulin dose (IU/kg) 0.74 ± 0.26 0.72 ± 0.26 0.70 ± 0.25 0.66 ± 0.24 <0.001 0.005 SBP (mmHg) 118 ± 10 127 ± 10 136 ± 11 156 ± 16 <0.001 <0.001 DBP (mmHg) 80 ± 9 80 ± 10 79 ± 10 79 ± 11 0.39 0.022 PP (mmHg) 38 ± 5 48 ± 2 57 ± 3 76 ± 12 <0.001 <0.001 Mean arterial pressure (mmHg) 80 ± 9 82 ± 10 85 ± 10 92 ± 11 <0.001 <0.001 History of CVD (%) 4 6 7 19 <0.001 <0.001 History of smoking (%) 47 45 47 50 0.109 0.241 Antihypertensive medication (%) 24 28 38 62 <0.001 <0.001 eGFR (mL/min/1.73 m2) 92 ± 30 93 ± 31 90 ± 34 87 ± 34 <0.001 <0.001 Diabetic nephropathy (%) 13 15 20 40 <0.001 <0.001 Values are expressed as means ± SD, percent, or median (interquartile range).
eGFR, estimated glomerular filtration rate.
- Table 2
Baseline characteristics according to occurrence of an incident CVD event (coronary event, stroke, peripheral vascular event) and progression in renal status (defined as any increase in albuminuria level or progression to ESRD) during follow-up
Incident CVD event Progression in renal status Event No event Progressors Nonprogressors N 269 2,698 373 2,830 Age (years) 49 ± 10* 37 ± 12 39 ± 12 38 ± 13 Age at onset (years) 17 ± 11 17 ± 11 15 ± 11† 17 ± 11 HbA1c (%) 8.8 ± 1.6* 8.4 ± 1.5 9.4 ± 1.7† 8.3 ± 1.4 Total cholesterol (mmol/L) 5.3 ± 1.2* 4.9 ± 0.9 5.4 ± 1.3† 4.9 ± 0.9 SBP (mmHg) 148 ± 20* 132 ± 17 141 ± 21† 132 ± 17 DBP (mmHg) 81 ± 10* 79 ± 10 83 ± 10† 79 ± 10 PP (mmHg) 66 ± 18* 52 ± 14 58 ± 18† 54 ± 15 Mean arterial pressure (mmHg) 90 ± 10* 83 ± 9 89 ± 10† 83 ± 9 History of CVD (%) 34* 5 12† 7 History of smoking (%) 60* 40 61† 39 Antihypertensive medication (%) 77* 31 60† 35 eGFR (mL/min/1.73 m2) 57 ± 33* 90 ± 31 68 ± 41† 88 ± 32 Diabetic nephropathy 59* 15 NA NA - Table 3
Cox regression analysis for an incident CVD event (coronary event, stroke, peripheral vascular event) and progression in renal status (defined as any increase in albuminuria level or progression to ESRD)
Incident CVD event Progression in renal status HR (95% CI) P value HR (95% CI) P value Age (years) 1.06 (1.04–1.08) <0.001 1.00 (0.99–1.02) 0.81 Male sex 1.11 (0.79–1.54) 0.55 2.01 (1.47–2.76) <0.001 HbA1c (%) 1.06 (0.95–1.18) 0.32 1.41 (1.30–1.53) <0.001 Total cholesterol (mmol/L) 1.26 (1.10–1.45) 0.001 1.19 (1.04–1.37) 0.01 eGFR (mL/min/1.73 m2) 0.99 (0.98–0.99) <0.001 1.00 (0.99–1.01) 0.88 History of smoking 1.45 (1.20–1.59) 0.001 1.20 (0.92–1.41) 0.15 Antihypertensive medication 0.43 (0.31–0.71) <0.001 0.58 (0.42–0.81) 0.001 PP (per 10 mmHg) 1.22 (1.10–1.34) <0.001 1.00 (0.89–1.12) 0.96 Variables are from baseline.
eGFR, estimated glomerular filtration rate; HR, hazard ratio.
- Table 4
Cox regression analysis for an incident CVD event (coronary event, stroke, peripheral vascular event) in patients by albuminuria status at baseline
CVD event Normoalbuminuria Microalbuminuria Macroalbuminuria HR (95% CI) P value HR (95% CI) P value HR (95% CI) P value Age (years) 1.08 (1.04–1.11) <0.001 1.09 (1.05–1.14) <0.001 1.04 (1.01–1.07) 0.009 Male sex 1.24 (0.67–2.28) 0.49 1.12 (0.43–2.95) 0.82 1.15 (0.67–1.98) 0.68 HbA1c (%) 1.14 (0.88–1.47) 0.33 1.29 (0.95–1.76) 0.11 1.04 (0.89–1.22) 0.61 Total cholesterol (mmol/L) 1.44 (1.05–1.98) 0.02 0.92 (0.55–1.52) 0.73 1.24 (1.02–1.52) 0.03 eGFR (mL/min/1.73 m2) 0.99 (0.97–1.01) 0.23 1.01 (0.99–1.03) 0.31 0.99 (0.98–1.00) 0.046 History of smoking 1.52 (1.10–1.74) 0.02 1.26 (0.15–1.70) 0.52 1.31 (0.84–1.59) 0.17 Antihypertensive medication 0.50 (0.27–0.95) 0.03 0.69 (0.26–1.82) 0.46 0.96 (0.23–4.10) 0.96 PP (per 10 mmHg) 1.31 (1.07–1.61) 0.009 1.41 (1.04–1.93) 0.03 1.18 (1.03–1.38) 0.02 Variables are from baseline.
eGFR, estimated glomerular filtration rate; HR, hazard ratio.
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