Is pulse pressure a predictor of new-onset diabetes in high-risk hypertensive patients?: a subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial.
Is pulse pressure a predictor of new-onset diabetes in high-risk hypertensive patients?: a subanalysis of the Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial.
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DOI：
10.2337/dc09-1447
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发表时间：
2010-05
期刊：
影响因子：
16.2
通讯作者：
Nakao K
中科院分区：
文献类型：
--
作者：
Yasuno S;Ueshima K;Oba K;Fujimoto A;Hirata M;Ogihara T;Saruta T;Nakao K
高血压患者患糖尿病的风险增加。越来越多的证据表明，代谢紊乱和动脉僵硬度增加之间存在密切关系。在这里，我们研究了日本高血压患者的脉压与新发糖尿病风险之间的关系。坎地沙坦抗高血压生存评价（CASE-J）试验在4，728例高风险日本高血压患者中检查了坎地沙坦和坎地沙坦对心血管事件发生率的影响。在本研究中，我们分析了2,685例基线时无糖尿病的患者（男性1,471例;平均年龄63.7岁;平均BMI 24.8 kg/m2）基线时脉压与新发糖尿病之间的关系，作为CASE-J试验的亚组分析。在3.3 ± 0.8年的随访期间，97例患者（3.6%）发生糖尿病。在多重考克斯回归分析中，脉压是新发糖尿病的独立预测因子（风险比[HR]每增加1 SD 1.44 [95% CI 1.15-1.79]），男性、BMI和额外使用利尿剂也是如此，而年龄和心率不是。考虑收缩压和舒张压（DBP）的新发糖尿病HR图显示，较高的脉压和较低的DBP（表明脉压增加主要是由于动脉僵硬度增加）与新发糖尿病的风险密切相关。脉压是日本高危高血压患者新发糖尿病的独立预测因子。动脉硬化增加可能与糖尿病的发展有关。
Hypertensive patients have an increased risk of developing diabetes. Accumulating evidence suggests a close relation between metabolic disturbance and increased arterial stiffness. Here, we examined the association between pulse pressure and the risk of new-onset diabetes in high-risk Japanese hypertensive patients. The Candesartan Antihypertensive Survival Evaluation in Japan (CASE-J) trial examined the effects of candesartan and amlodipine on the incidence of cardiovascular events in 4,728 high-risk Japanese hypertensive patients. In the present study, we analyzed the relationship between pulse pressure at baseline and new-onset diabetes in 2,685 patients without diabetes at baseline (male 1,471; mean age 63.7 years; mean BMI 24.8 kg/m2) as a subanalysis of the CASE-J trial. During 3.3 ± 0.8 years of follow-up, 97 patients (3.6%) developed diabetes. In multiple Cox regression analysis, pulse pressure was an independent predictor for new-onset diabetes (hazard ratio [HR] per 1 SD increase 1.44 [95% CI 1.15–1.79]) as were male sex, BMI, and additional use of diuretics, whereas age and heart rate were not. Plots of HRs for new-onset diabetes considering both systolic and diastolic blood pressure (DBP) revealed that a higher pulse pressure with a lower DBP, indicating that the increased pulse pressure was largely due to increased arterial stiffness, was strongly associated with the risk of new-onset diabetes. Pulse pressure is an independent predictor of new-onset diabetes in high-risk Japanese hypertensive patients. Increased arterial stiffness may be involved in the development of diabetes.
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影响因子：
5.4
作者：
Fukui, T;Rahman, M;Fukiyama, K
通讯作者：
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影响因子：
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作者：
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