1.1 DIABETES AND CENTRAL BLOOD PRESSURE IN CORONARY PATIENTS

DOI

10.1016/j.artres.2016.10.002How to use a DOI?

Abstract

Background: Relative (represented by pulsatility) as well as absolute (pulse pressure) changes of central blood pressure (BP) were shown to predict cardiovascular (CV) complications in coronary patients. However, the influence of diabetes (a major CV risk factor) on the values of BP-derived indices is unknown.

Methods: The study group consisted of 1239 patients with coronary artery disease (988 men and 251 women mean age: 58.6±10.1 years) undergoing coronary angiography. Demographic and clinical information as well as cuff brachial and invasive ascending aortic BP during catheterization were obtained. Diabetes was defined as being treated for diabetes or having fasting glucose ≥ 7.0mmol/l. We defined pulsatility as the ratio of pulse pressure (PP) to mean BP and pulsatility index as the ratio of PP to diastolic BP. Multivariate regression analysis was used to assess the effect of diabetes on the values of BP-derived indices.

Results: Diabetes was present in 222 (17.9%) patients. Among them 84 (37.8%) were prescribed insulin, 96 (43.2%) oral drugs, and 42 (18.9%) only diet. β-blockers were prescribed to 82.4% vs 87.2% (p=NS), ACE-inhibitors/sartans to 75.2% vs 57.6% (p<0.05), Ca blockers to 21.2% vs 15.7% (p<0.05), diuretics to 41.0% vs 20.1% (p<0.05), for diabetics and non-diabetics respectively. The effect of diabetes on central pressure is presented in the table. Diabetes was not independently related to the value of peripheral BP-derived indices.

Conclusion: Diabetes is independently related to the higher values of central PP, pulsatility and pulsatility index. This may contribute to higher CV risk in diabetics.

BP – related variables	The mean difference between diabetics and non-diabetics (95% CI)
	Univariate	Multivariate*
Systolic blood pressure [mmHg]	4.37 (1.03 – 7.70)	2.28 (−1.22 – 5.78)
Diastolic blood pressure [mmHg]	−1.16 (−2.82 – 0.50)	−1.11 (−2.98 – 0.76)
Mean blood pressure [mmHg]	0.66 (−1.34 – 2.66)	0.01 (−2.22 – 2.23)
Pulse pressure [mmHg]	5.53 (2.89 – 8.17)	3.39 (0.80 – 5.99)
Pulsatility	0.05 (0.03 – 0.08)	0.03 (0.01 – 0.06)
Pulsatility index	0.09 (0.05 – 0.13)	0.06 (0.02 – 0.10)

*

Age, sex, brachial systolic and diastolic BP, ejection fraction, extent of coronary atherosclerosis, NYHA class, heart rate, creatinine level, risk factors and treatment are included in the model.

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TY  - JOUR
AU  - Piotr Jankowski
AU  - Dorota Debicka-Dabrowska
AU  - Malgorzata Kloch-Badelek
AU  - Leszek Bryniarski
AU  - Kalina Kawecka-Jaszcz
AU  - Danuta Czarnecka
PY  - 2016
DA  - 2016/11/24
TI  - 1.1 DIABETES AND CENTRAL BLOOD PRESSURE IN CORONARY PATIENTS
JO  - Artery Research
SP  - 48
EP  - 48
VL  - 16
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2016.10.002
DO  - 10.1016/j.artres.2016.10.002
ID  - Jankowski2016
ER  -