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

Rachel Climie*; Petr Otahal; Martin Schultz; James Fell; Velandai Srikanth; James Sharman

doi:10.1016/j.artres.2015.10.024

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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.2015.10.024 How 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.
Open Access: This is an open access article distributed under the CC BY-NC license.

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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.2015.10.024 How to use a DOI?
Open Access: This is an open access article distributed under the CC BY-NC license.

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ris enw bib

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  -

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