Effect of target systolic blood pressure on cardiovascular events in patients with hypertension complicated with type 2 diabetes / 中国实用护理杂志

ABSTRACT

Objective To compare the effects of target systolic blood pressure on cardiovascular events in patients with hypertension and type 2 diabetes after antihypertensive drugs. Methods This study was a retrospective cohort study. Randomly selected from March 2014 to March 2017, 1563 patients with hypertension and type 2 diabetes diagnosed in the Department of Cardiology of the Tiemei Group General Hospital. There was no cardiovascular complications at admission. After admission, the population variables of each patient were recorded. Each patient was adjusted for blood pressure and blood glucose according to the doctor's advice after admission. After the hospital was discharged, the patient was followed up for blood pressure every week. The follow-up was 3-4 months. The average systolic blood pressure of each patient was recorded as the target systolic pressure. The patients who were followed up were divided into three groups according to the target systolic pressure value, namely ≤120 mmHg(1 mmHg=0.133 kPa) group,>120-130 mmHg group,>130-140 mmHg group. After that, it was changed to a weekly telephone follow-up of the nurses for a total of 3 years. The cardiovascular disease (CVD) occurred in these patients within 3 years were recorded. The CVD was used as the dependent variable, and the systolic blood pressure of each group was used as the independent variable to do COX. Proportional risk regression analysis, the hazard ratio (HR) of each group of concurrent CVD. Taking CVD as the dependent variable, HR of CVD with >130-140 mmHg group was taken as the reference value, and all population variables were used as independent variables, respectively, ≤120 mmHg group,>120-130 mmHg group and>130-140 mmHg group combined with CVD risk ratio. Results During the 3-year follow-up period, 1401 patients with blood pressure met 104 patients with systolic blood pressure ≤120 mmHg, 543 patients with >120-130 mmHg, and 754 patients with >130-140 mmHg. The incidence of CVD in the three groups was 14.4％(15/104), 8.8％(48/543), 7.0％(53/754). HR of CVD were 1.66, 0.96, 0.53 in≤120 mmHg group,>120- 130 mmHg group,>130-140 mmHg group .Compared with >130-140 mmHg group, the risk ratio of CVD in all subgroups of≤120 mmHg group was statistically increased (HR>1, P<0.05). Compared with >130-140 mmHg, >120-130 mmHg group with 65-79 years old, combined with more than 3 groups of antihypertensive drugs, patients with diuretics showed a statistically significant increase in the risk ratio of CVD (HR>1, P <0.05). Conclusions The target systolic blood pressure of patients with hypertension and type 2 diabetes should be >130-140 mmHg. For patients aged 65-79 years, more than 3 groups of antihypertensive drugs are used. Patients with diuretics should have a target systolic blood pressure of >130-140 mmHg.