Blood pressure and pulse pressure effects on renal outcomes in the Veterans Affairs Diabetes Trial (VADT)

Robert J. Anderson; Gideon D. Bahn; Nicholas V. Emanuele; Jennifer B. Marks; William C. Duckworth

doi:10.2337/dc14-0284

Blood pressure and pulse pressure effects on renal outcomes in the Veterans Affairs Diabetes Trial (VADT)

Robert J. Anderson, Gideon D. Bahn, Nicholas V. Emanuele, Jennifer B. Marks, William C. Duckworth

Research output: Contribution to journal › Article › peer-review

20 Scopus citations

Abstract

OBJECTIVE Blood pressure (BP) control for renal protection is essential for patients with type 2 diabetes. Our objective in this analysis of Veterans Affairs Diabetes Trial (VADT) data was to learn whether on-study systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) affected renal outcomes measured as albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR).

RESEARCH DESIGN AND METHODS The VADT was a prospective, randomized study of 1,791 veterans with type 2 diabetes to determine whether intensive glucose control preventedmajor cardiovascular events. In this post hoc study, time-varying covariate survival analyses and hazard ratios (HR) were used to determine worsening of renal outcomes.

RESULTS Compared with SBP 105-129 mmHg, the risk of ACR worsening increased significantly for SBP 130-139 mmHg (HR 1.88 [95% CI 1.28-2.77]; P = 0.001) and for SBP ≥140 mmHg (2.51 [1.66-3.78]; P <0.0001). Compared with a PP range of 40-49 mmHg, PP

CONCLUSIONS SBP ≥130 mmHg and PP >60 mmHg were associated with worsening ACR. The results suggest that treatment of SBP to

Original language	English (US)
Pages (from-to)	2782-2788
Number of pages	7
Journal	Diabetes care
Volume	37
Issue number	10
DOIs	https://doi.org/10.2337/dc14-0284
State	Published - Oct 1 2014
Externally published	Yes

All Science Journal Classification (ASJC) codes

Internal Medicine
Endocrinology, Diabetes and Metabolism
Advanced and Specialized Nursing

Access to Document

10.2337/dc14-0284

Cite this

@article{9d3d05bdc6cb4a6cb522eae0f14d9633,

title = "Blood pressure and pulse pressure effects on renal outcomes in the Veterans Affairs Diabetes Trial (VADT)",

abstract = "OBJECTIVE Blood pressure (BP) control for renal protection is essential for patients with type 2 diabetes. Our objective in this analysis of Veterans Affairs Diabetes Trial (VADT) data was to learn whether on-study systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) affected renal outcomes measured as albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR).RESEARCH DESIGN AND METHODS The VADT was a prospective, randomized study of 1,791 veterans with type 2 diabetes to determine whether intensive glucose control preventedmajor cardiovascular events. In this post hoc study, time-varying covariate survival analyses and hazard ratios (HR) were used to determine worsening of renal outcomes.RESULTS Compared with SBP 105-129 mmHg, the risk of ACR worsening increased significantly for SBP 130-139 mmHg (HR 1.88 [95% CI 1.28-2.77]; P = 0.001) and for SBP ≥140 mmHg (2.51 [1.66-3.78]; P <0.0001). Compared with a PP range of 40-49 mmHg, PP CONCLUSIONS SBP ≥130 mmHg and PP >60 mmHg were associated with worsening ACR. The results suggest that treatment of SBP to ",

author = "Anderson, {Robert J.} and Bahn, {Gideon D.} and Emanuele, {Nicholas V.} and Marks, {Jennifer B.} and Duckworth, {William C.}",

note = "Publisher Copyright: {\textcopyright} 2014 by the American Diabetes Association.",

year = "2014",

month = oct,

day = "1",

doi = "10.2337/dc14-0284",

language = "English (US)",

volume = "37",

pages = "2782--2788",

journal = "Diabetes Care",

issn = "1935-5548",

publisher = "American Diabetes Association Inc.",

number = "10",

}

TY - JOUR

T1 - Blood pressure and pulse pressure effects on renal outcomes in the Veterans Affairs Diabetes Trial (VADT)

AU - Anderson, Robert J.

AU - Bahn, Gideon D.

AU - Emanuele, Nicholas V.

AU - Marks, Jennifer B.

AU - Duckworth, William C.

PY - 2014/10/1

Y1 - 2014/10/1

N2 - OBJECTIVE Blood pressure (BP) control for renal protection is essential for patients with type 2 diabetes. Our objective in this analysis of Veterans Affairs Diabetes Trial (VADT) data was to learn whether on-study systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) affected renal outcomes measured as albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR).RESEARCH DESIGN AND METHODS The VADT was a prospective, randomized study of 1,791 veterans with type 2 diabetes to determine whether intensive glucose control preventedmajor cardiovascular events. In this post hoc study, time-varying covariate survival analyses and hazard ratios (HR) were used to determine worsening of renal outcomes.RESULTS Compared with SBP 105-129 mmHg, the risk of ACR worsening increased significantly for SBP 130-139 mmHg (HR 1.88 [95% CI 1.28-2.77]; P = 0.001) and for SBP ≥140 mmHg (2.51 [1.66-3.78]; P <0.0001). Compared with a PP range of 40-49 mmHg, PP CONCLUSIONS SBP ≥130 mmHg and PP >60 mmHg were associated with worsening ACR. The results suggest that treatment of SBP to

AB - OBJECTIVE Blood pressure (BP) control for renal protection is essential for patients with type 2 diabetes. Our objective in this analysis of Veterans Affairs Diabetes Trial (VADT) data was to learn whether on-study systolic BP (SBP), diastolic BP (DBP), and pulse pressure (PP) affected renal outcomes measured as albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR).RESEARCH DESIGN AND METHODS The VADT was a prospective, randomized study of 1,791 veterans with type 2 diabetes to determine whether intensive glucose control preventedmajor cardiovascular events. In this post hoc study, time-varying covariate survival analyses and hazard ratios (HR) were used to determine worsening of renal outcomes.RESULTS Compared with SBP 105-129 mmHg, the risk of ACR worsening increased significantly for SBP 130-139 mmHg (HR 1.88 [95% CI 1.28-2.77]; P = 0.001) and for SBP ≥140 mmHg (2.51 [1.66-3.78]; P <0.0001). Compared with a PP range of 40-49 mmHg, PP CONCLUSIONS SBP ≥130 mmHg and PP >60 mmHg were associated with worsening ACR. The results suggest that treatment of SBP to

UR - http://www.scopus.com/inward/record.url?scp=84908206119&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84908206119&partnerID=8YFLogxK

U2 - 10.2337/dc14-0284

DO - 10.2337/dc14-0284

M3 - Article

C2 - 25048382

AN - SCOPUS:84908206119

VL - 37

SP - 2782

EP - 2788

JO - Diabetes Care

JF - Diabetes Care

SN - 1935-5548

IS - 10

ER -

Blood pressure and pulse pressure effects on renal outcomes in the Veterans Affairs Diabetes Trial (VADT)

Abstract

All Science Journal Classification (ASJC) codes

Access to Document

Other files and links

Fingerprint

Cite this