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Reservoir-Excess Pressure Parameters Independently Predicts Cardiovascular Events in Individuals With Type 2 Diabetes.

Aizawa, K; Casanova, F; Gates, PE; Mawson, DM; Gooding, KM; Strain, WD; Östling, G; ... Hughes, AD; + view all (2021) Reservoir-Excess Pressure Parameters Independently Predicts Cardiovascular Events in Individuals With Type 2 Diabetes. Hypertension , 78 (1) pp. 40-50. 10.1161/HYPERTENSIONAHA.121.17001. Green open access

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Abstract

The parameters derived from reservoir-excess pressure analysis have prognostic utility in several populations. However, evidence in type 2 diabetes (T2DM) remains scarce. We determined if these parameters were associated with T2DM and whether they would predict cardiovascular events in individuals with T2DM. We studied 306 people with T2DM with cardiovascular disease (CVD; DMCVD, 70.4±7.8 years), 348 people with T2DM but without CVD (diabetes mellitus, 67.7±8.4 years), and 178 people without T2DM or CVD (control group [CTRL], 67.2±8.9 years). Reservoir-excess pressure analysis-derived parameters, including reservoir pressure integral, peak reservoir pressure, excess pressure integral, systolic rate constant, and diastolic rate constant, were obtained by radial artery tonometry. Reservoir pressure integral was lower in DMCVD diabetes mellitus and than CTRL. Peak reservoir pressure was lower, and excess pressure integral was greater in DMCVD diabetes mellitus than and CTRL. Systolic rate constant was lower in a stepwise manner among groups (DMCVD< diabetes mellitus <CTRL). Diastolic rate constant was greater in DMCVD than CTRL. In the subgroup of individuals with T2DM (n=642), 14 deaths (6 cardiovascular and 9 noncardiovascular causes), and 108 cardiovascular events occurred during a 3-year follow-up period. Logistic regression analysis revealed that reservoir pressure integral (odds ratio, 0.59 [95% CI, 0.45-0.79]) and diastolic rate constant (odds ratio, 1.60 [95% CI, 1.25-2.06]) were independent predictors of cardiovascular events during follow-up after adjusting for conventional risk factors (both P<0.001). Further adjustments for potential confounders had no influence on associations. These findings demonstrate that altered reservoir-excess pressure analysis-derived parameters are associated with T2DM. Furthermore, baseline values of reservoir pressure integral and diastolic rate constant independently predict cardiovascular events in individuals with T2DM, indicating the potential clinical utility of these parameters for risk stratification in T2DM.

Type: Article
Title: Reservoir-Excess Pressure Parameters Independently Predicts Cardiovascular Events in Individuals With Type 2 Diabetes.
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/HYPERTENSIONAHA.121.17001
Publisher version: http://doi.org/10.1161/HYPERTENSIONAHA.121.17001
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Aging, blood pressure, cardiovascular disease, hemodynamics, risk factor
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
URI: https://discovery.ucl.ac.uk/id/eprint/10129780
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