Adverse Renal Outcomes Reduced With Lower BP in Type 1 Diabetes
Risk for adverse renal outcomes are reduced with lower blood pressure in type 1 diabetes.
HealthDay News -- For patients with type 1 diabetes, blood pressure (BP) of <120/70 mm Hg is associated with a substantially reduced risk of adverse renal outcomes, according to a study published in Diabetes Care.
Elaine Ku, MD, from the University of California in San Francisco, and colleagues compared BP levels and their association with the risk of renal outcomes among 1441 participants with type 1 diabetes aged 13 to 39 years who had been randomized to receive intensive vs conventional glycemic control. Time-updated systolic BP (SBP) and diastolic BP (DBP) were the exposures of interest.
The researchers identified 84 cases of stage III chronic kidney disease (CKD) and 169 cases of macroalbuminuria during a median follow-up of 24 years. Compared with SBPs between 130 mm Hg and 140 mm Hg, SBP in the <120 mm Hg range correlated with a 0.59 times risk of macroalbuminuria and a 0.32 times risk of stage III CKD, in adjusted models. Compared with DBPs between 80 mm Hg and 90 mm Hg, DBP in the <70 mm Hg range correlated with a 0.73 times risk of macroalbuminuria and a 0.47 times risk of stage III CKD. There was no interaction between BP and glycemic control strategy.
"A lower BP (<120/70 mm Hg) was associated with a substantially lower risk of adverse renal outcomes, regardless of the prior assigned glycemic control strategy," the researchers wrote.
- Ku E, McCulloch CE, Mauer M, Gitelman SE, Grimes BA, Hsu C-Y. Association Between Blood Pressure and Adverse Renal Events in Type 1 Diabetes. Diabetes Care. 2016 Nov 21. doi:10.2337/dc16-0857 [Epub ahead of print].