Blood Pressure and Development of Cardiovascular Disease in Koreans With Type 2 Diabetes Mellitus

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 73; no. 2; pp. 319 - 326
• Main Authors: Kim, Mee Kyoung, Han, Kyungdo, Koh, Eun Sil, Kim, Eun Sook, Lee, Min-Kyung, Nam, Ga Eun, Kwon, Hyuk-Sang
• Format: Journal Article
• Language: English
• Published: United States American Heart Association, Inc 01.02.2019
• Subjects: blood pressure; diabetes mellitus; cardiovascular diseases; hypertension; Korea
• ISSN: 0194-911X; 1524-4563; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.118.12160

The objective of this study was to investigate the optimal blood pressure (BP) target to prevent development of cardiovascular diseases (CVDs) in Korean subjects with type 2 diabetes mellitus. Using the Korean National Health Insurance Service database, 2 262 725 subjects with type 2 diabetes mellitus who underwent regular health checks between 2009 and 2012 were included. Subjects with previous CVDs were excluded. Participants were grouped by 10-mm Hg intervals of observed systolic BP (SBP) by 5-mm Hg intervals of diastolic BP. There were 124 466 deaths (5.50%), 67 235 cases of stroke (2.97%), and 41 726 myocardial infarctions (1.84%) during a median follow-up of 6.5 years. Compared with SBP 110 to 119 mm Hg, there was no increased risk among subjects with SBP 120 to 129 mm Hg, but SBP ≥130 mm Hg was associated with a significant increase in the incidence of CVDs. SBP 130 to 139 mm Hg was associated with a significant increase in the incidence of stroke (hazard ratio, 1.15; 95% CI, 1.12–1.18) and myocardial infarctions (hazard ratio, 1.05; 95% CI, 1.02–1.09) compared with SBP 110 to 119 mm Hg. Subjects with diastolic BP 80 to 84 mm Hg had a higher risk of CVDs than subjects with diastolic BP 75 to 79 mm Hg. The overall relationship between BP and CVD risk was positive, with a greater strength observed for younger age groups. The optimal cutoff for Korean patients with type 2 diabetes mellitus associated with lower CVD risk may be 130 mm Hg for SBP or 80 mm Hg for diastolic BP.