Pulse pressure, a good surrogate marker for arterial stiffness, is a good predictor of the risk of cardiovascular events in patients with type 2 diabetes, according to a report by Welsh investigators. Arterial stiffening, which occurs at an early stage in diabetes, will be an increasingly important risk factor in an aging population.
Pulse pressure (ie, the difference between systolic and diastolic blood pressure) is known to be a major determinant of cardiovascular risk in both normotensive and hypertensive patients. To determine the relationship between pulse pressure and cardiovascular risk in patients with type 2 diabetes, J.R. Cockcroft, of the University of Wales College of Medicine, Cardiff, and associates abstracted data on 2,911 cases from the Cardiff Diabetes Database.
During a period of 4 years, 574 coronary heart disease events, 168 cerebrovascular disease events, and 157 peripheral vascular disease events were recorded. The investigators used various mathematical techniques to analyze the data and found that the results were generally consistent.
Univariate analysis showed that both systolic blood pressure and pulse pressure were significantly related to cardiovascular disease. Pulse pressure, however, was more strongly related to peripheral vascular disease than was systolic blood pressure.
After adjustment for other variables, total cholesterol and low-density lipoprotein cholesterol were significantly associated with systolic blood pressure. Total cholesterol and high-density lipoprotein cholesterol were the variables most strongly associated with pulse pressure after age.
These findings suggest that pulse pressure and systolic blood pressure are the best predictors of cardiovascular disease in patients with type 2 diabetes, Cockcroft said. The effects of dyslipidemia on cardiovascular risk in these patients may be mediated through pulse pressure and increased pulse pressure.
Incoming search terms
cardiovascular,type 2,diabetes,heart diseases,blood pressure
