Association Of Blood Pressure With Cardiovascular Disease Events In Patients With Type 2 Diabetes Mellitus And Essential Hypertension

Objective To explore the influence of blood pressue (BP) on cardiovascular diseaseevents(nonfatal myocardial, hospitalization for congestive heart failure or unstable angina,coronary revascularization)in patients with type 2 diabetes mellitus (T2DM) and essentialhypertension (EH) when their SBP＞140 mm Hg(1 mm Hg=0.133 kPa),≤140 mm Hg,≤130mm Hg,≤120 mm Hg, respectively. And then preliminarily determine the proper bloodpressure in patients with T2DM and EH.Methods To select the information of patients with T2DM and EH in our hospital in 2005,including(1)age, sex,body-mass index(kg/m2),cigarette-smoking status(current,former,never),diastolic blood pressure(one time every 7～14 days), fasting plasma glucose(one time every7～14 days),cholesterol and triglyceride(one time every 6～12 months);(2)the incidenceof nonfatal myocardial, heart failure, unstalbe angina , coronary revascularization in 5 years.There were 70 patients in the SBP＞140 mm Hg,≤140 mm Hg,≤130 mm Hg,≤120 mm Hg,respectively. Their characteristics at baseline including age, sex, BMI, cigarette-smoking status,DBP, fasting plasma glucose and cholesterol and triglyceride were no significant differences (P＞0.05). An analysis was conducted in 280 patients to study the influence of nonfatalmyocardial,heart failure, unstalbe angina, coronary revascularization when their SBP＞140mm Hg,≤140 mm Hg,≤130 mm Hg,≤120 mm Hg, respectively.Results(1)There were 18 patients with nonfatal myocardial,16 patients with heartfailure,23 patients with unstalbe angina and 11 patients with coronary revascularization whentheir SBP＞140 mm Hg ; 7 patients with nonfatal myocardial,5 patients with heart failure,10patients with unstalbe angina and 3 patient with coronary revascularization when their SBP≤140 mm Hg; 9 patients with nonfatal myocardia,8 patients with heart failure,9 patients withunstalbe angina and 5 patient with coronary revascularization when their SBP≤130 mm Hg; 6patients with nonfatal myocardia,7 patients with heart failure,14 patient with unstalbe anginaand 3 patient with coronary revascularization when their SBP≤120 mm Hg .(2)The incidenceof nonfatal myocardial,heart failure, unstalbe angina, coronary revascularization was nosignificant differences when making a comparison among the groups SBP≤140 mm Hg,≤130mm Hg,≤120 mm Hg (P＞0.05).(3)The incidence of cardiovascular disease events in thegroup SBP＞140 mm Hg was markedly higher than the other three groups SBP≤140 mm Hg,≤130 mm Hg,≤120 mm Hg﹙P＜0.05﹚. ConclusiConclusion Lowing blood pressure can reduce the incidence of cardiovascular diseaseevents for the patients with T2DM and EH. But it should not be lower than needed, SBP≤140mm Hg is recommended as a propel level.