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Abstract: PO0973

Risk of Cardiovascular Disease, CKD, and Cardiovascular Mortality According to 2017 ACC/AHA Blood Pressure Categories in Diabetes

Session Information

Category: Diabetic Kidney Disease

  • 602 Diabetic Kidney Disease: Clinical

Authors

  • Kim, Miryung, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
  • Lee, Jun Young, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
  • Yang, Jae Won, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
  • Choi, Seung-Ok, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
  • Kim, Jae seok, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
  • Eom, Minseob, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
  • Shin, Hanwul, Yonsei University Wonju College of Medicine, Wonju, Korea (the Republic of)
Background

The association between blood pressure (BP) and cardiovascular disease (CVD) and chronic kidney disease (CKD) in diabetes patients remains unclear.

Methods

By using an analysis based on the National Health Insurance Database of Korea, 8, 922, 940 persons were screened between 2009 to 2014. We determined the BP status of 490,352 persons: Level 1 ((systolic <120 mmHg and diastolic <80 mmHg, n = 109,427), level 2 (systolic 120-129 mmHg and diastolic <80 mmHg, n = 98,360), level 3 (systolic 130-139 mmHg or diastolic 80-89 mmHg, n= 188,728), and level 4 (systolic ≥140 mmHg or diastolic ≥90 mmHg, n= 93,837).

Results

Overall, 490,352 diabetes patients were analysed over a mean follow-up of 5 years and 6,508 CVD events occurred. Compared to people with BP levels 1, the adjusted hazard ratios (HRs) for CVD in people with BP levels 2, 3, and 4 were 1.07 (95% confidence interval [CI], 0.98-1.16), 1.12 (95% CI, 1.04-1.20) and 1.17 (95% CI, 1.08-1.26), respectively. There were also increased risks of CKD [1.18 (95% CI, 1.12-1.24) and 1.22 (95% CI, 1.15-1.29)] and CVD mortality [1.31 (95% CI, 1.09-1.56) and 1.91 (95% CI, 1.58-2.32)] among subjects with BP levels 3 and 4 compared with those with BP level 1.

Conclusion

These findings provide evidence supporting the 2017 ACC/AHA guidelines for BP targets in diabetes patients.

Table 1

Figure 1. Hazard ratios for cardiovascular disease according to systolic blood pressure in diabetes men patients.

Funding

  • NIDDK Support