In Type 2 DM, Proteinuria With SBP <130 Ups CVD Mortality
(HealthDay News) – Patients with type 2 diabetes, proteinuria, and systolic blood pressure (BP) <130 mmHg are at an increased risk of total and cardiovascular disease (CVD) mortality, suggesting that proteinuria should be taken into account when establishing target systolic BP levels for prevention of fatal CVD events.
In an effort to determine the interaction between BP and proteinuria on total and CVD mortality, Teemu Vepsäläinen, MD, of the University of Turku in Finland, and colleagues conducted a prospective, population-based study involving 881 middle-aged patients with poorly controlled type 2 diabetes without CVD who were followed for as long as 18 years. Patients were grouped according to systolic BP (<130, 130–139, 140–159, ≥160mmHg) and by presence or absence of proteinuria (≤150 or >150mg/L).
The researchers found that, overall, 68.9% of patients died during follow-up, including 44.8% due to CVD. Patients with proteinuria and systolic BP <130mmHg had an approximately two-fold higher total and CVD mortality than those with systolic BP between 130–139mmHg, and a 1.6-fold higher total and CVD mortality than those with systolic BP of 140–159mmHg.
"To our knowledge, this is the first large population-based long-term follow-up study to investigate the impact of systolic BP on total and CVD mortality in patients with type 2 diabetes with and without proteinuria," the authors write.