Effect of baseline systolic blood pressure on new-onset cardio-and cerebrovascular events in diabetic population

Objective To study the effect of baseline systolic blood pressure（SBP）level on new-onset cardio-and cerebrovascular events in diabetic patients.Methods This was a prospective cohort study.In a total of 101 510 employees of Kailuan Group who had received a physical examination in the period from Jul.2006 to Oct.2007,8306 subjects who had a fasting plasma glucose level of≥7.0 mmol/L or who had been diagnosed with diabetes despite a fasting plasma glucose concentration of ＜7.0 mmol/L were selected and thus were taking insulin or hypoglycemic drugs.In the 38-53（48.1±3.1） months of follow-up,we collected the cardio-cerebrovascular events every six months for the investigation of the effect of the baseline SBP on new-onset cardio-cerebrovascular events in the diabetic population were collected.Results With the increased level of baseline SBP,the mean age,BMI,TG,and HDL-C level significantly increased gradually in the diabetic population（P＜0.01）,and so did the TC and LDL-C level（P＜0.05）.Compared with baseline SBP＜120 mm Hg group,baseline SBP 120-＜130 mm Hg group and baseline SBP≥140 mm Hg group,SBP 130-＜140 mm Hg group had the lowest incidence regarding cardio/cerebral vascular events,cerebral infarction events,myocardial infarction,and cerebral hemorrhage events,with the first two respects presenting significant differences（P＜0.05）.A multivariate Cox’s proportional hazards regression analysis indicated that after adjustment for other risk factors,in the diabetic subjects complicated with hypertension,compared with baseline SBP 130-＜140 mm Hg group,the RR for cardio-cerebrovascular events in SBP＜120 mm Hg group,SBP 120-＜130 mm Hg group and SBP≥140 mm Hg group were 5.37（95% CI 2.24-12.87,P＜0.01）, 2.41（95% CI 1.11-5.22,P＜0.05） and 2.43（95% CI 1.35-4.36,P＜0.01）,respectively;the RR for cerebral infarction events in SBP＜120 mm Hg group and SBP≥140 mm Hg group were 6.16（95% CI 2.05-18.55,P＜0.01）and 2.65（95% CI 1.24-5.70,P＜0.05）.Conclusion The level of baseline SBP may affect the incidence of cardio/cerebral vascular events in diabetic population.In diabetic patients complicated with hypertention,those with SBP of approximately 130 to ＜140 mm Hg have the lowest incidence of cardio-cerebrovascular events and cerebral infarction events.