Artery Research

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Volume 12, Issue C, December 2015, Pages 45 - 45

4.5 A SYSTEMATIC REVIEW AND META-ANALYSIS OF CENTRAL TO BRACHIAL BLOOD PRESSURE AMPLIFICATION IN PATIENTS TYPE 2 DIABETES MELLITUS

Authors
Rachel Climie*1, Petr Otahal1, Martin Schultz1, James Fell2, Velandai Srikanth3, James Sharman1
1Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
2School of Human Life Sciences, University of Tasmania, Launceston, Tasmania, Australia
3Monash Medical Centre, Monash University, Melbourne, Victoria, Australia
Available Online 23 November 2015.
DOI
10.1016/j.artres.2015.10.024How to use a DOI?
Abstract

Background: Brachial blood pressure (BP) may not reflect central BP due to systolic BP (SBP) amplification. Patients with type 2 diabetes mellitus (T2DM) elicit vascular irregularities that may affect SBP amplification or other central BP indices (including pulse pressure [PP], augmentation pressure [AP] and augmentation index [AIx]). By systematic review and meta-analysis, this study aimed to determine the magnitude and variation of central-to-brachial SBP and PP amplification, AIx and AP in T2DM compared to non-diabetic controls.

Methods: Online databases were searched for published studies reporting invasive or non-invasive central and brachial SBP in T2DM and non-diabetic controls. Random effects meta-analyses and meta-regression were used to analyse the studies.

Results: We identified 17 studies with a total of 2,711 T2DM and 10,460 non-diabetic controls. There was no significant difference in SBP amplification between groups (T2DM = 10.8, non-diabetic = 10.2 mmHg; pooled estimate = 0.6 mmHg, 95%CI −0.3, 1.5, p = 0.21), but large variation in both (T2DM range = 2.0–16.6 mmHg, non-diabetic range = 1.0–16.1 mmHg). In the meta-regression, duration of T2DM explained 16.3% of the variance in the pooled data (p = 0.15); the difference in amplification between groups increasing by 0.3 mmHg per year of T2DM. PP amplification was not significantly different between groups (p = 0.16). AP, AIx and AIx corrected for heart rate were significantly higher in T2DM (p < 0.05 all).

Conclusions: Patients with T2DM have increased AP and AIx, but no difference in SBP (or PP) amplification compared to non-diabetic individuals. However, SBP amplification is highly variable and increases with duration of T2DM; altogether confirming that central systolic loading cannot be reliably estimated from brachial BP in T2DM.

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<Previous Article In Issue
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Journal
Artery Research
Volume-Issue
12 - C
Pages
45 - 45
Publication Date
2015/11/23
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2015.10.024How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

risenwbib
TY  - JOUR
AU  - Rachel Climie*
AU  - Petr Otahal
AU  - Martin Schultz
AU  - James Fell
AU  - Velandai Srikanth
AU  - James Sharman
PY  - 2015
DA  - 2015/11/23
TI  - 4.5 A SYSTEMATIC REVIEW AND META-ANALYSIS OF CENTRAL TO BRACHIAL BLOOD PRESSURE AMPLIFICATION IN PATIENTS TYPE 2 DIABETES MELLITUS
JO  - Artery Research
SP  - 45
EP  - 45
VL  - 12
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2015.10.024
DO  - 10.1016/j.artres.2015.10.024
ID  - Climie*2015
ER  -