Document Detail


Lower blood pressure associated with higher mortality in elderly diabetic patients (ZODIAC-12).
MedLine Citation:
PMID:  20621928     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: to investigate the relationship between blood pressure over time and mortality in elderly patients with type 2 diabetes mellitus (T2DM).
DESIGN: prospective observational cohort study.
SETTING: primary care, Zwolle, The Netherlands.
SUBJECTS: patients with T2DM aged 60 years and older (n = 881). The cohort was divided into two age categories: 60-75 years and older than 75 years.
METHODS: updated means for systolic, diastolic and pulse pressures were calculated after a median follow-up time of 9.8 years. These values were used as time-dependent covariates in a Cox proportional hazard model. Main outcome measures were all-cause and cardiovascular mortality.
RESULTS: all of the blood pressure measures were inversely related to all-cause mortality in elderly diabetic patients (>75 years). Furthermore, these relationships were specifically found in elderly patients treated with antihypertensive medication at baseline. A decrease of 10 mm Hg in systolic blood pressure, diastolic blood pressure and pulse pressure led to a mortality increase of 22% [95% confidence interval (95% CI): 13-31%], 30% [95% CI: 13%-46%] and 22% [95% CI: 11%-33%], respectively. In the low age group (60-75 years), no relationship was found between blood pressure and mortality.
CONCLUSIONS: blood pressure is a marker for mortality in elderly T2DM patients; however, the relationship is inverse.
Authors:
Kornelis J J van Hateren; Gijs W D Landman; Nanne Kleefstra; Klaas H Groenier; Adriaan M Kamper; Sebastiaan T Houweling; Henk J G Bilo
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Publication Detail:
Type:  Journal Article     Date:  2010-07-09
Journal Detail:
Title:  Age and ageing     Volume:  39     ISSN:  1468-2834     ISO Abbreviation:  Age Ageing     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-18     Completed Date:  2010-11-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375655     Medline TA:  Age Ageing     Country:  England    
Other Details:
Languages:  eng     Pagination:  603-9     Citation Subset:  IM    
Affiliation:
Diabetes Centre, Isala Clinics, Zwolle, The Netherlands. k.j.j.van.hateren@isala.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Antihypertensive Agents / therapeutic use
Blood Pressure*
Diabetes Mellitus, Type 2 / mortality*
Female
Humans
Hypertension / drug therapy,  mortality*
Male
Middle Aged
Netherlands / epidemiology
Proportional Hazards Models
Prospective Studies
Risk Factors
Chemical
Reg. No./Substance:
0/Antihypertensive Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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