Target of blood pressure control in elderly patients with type 2 diabetes and hypertension

Abstract

Objective To explore the target of blood pressure control in elderly patients with type 2 diabetes and hypertension. Methods A total of 707 elderly patients (male/female: 324/383) with type 2 diabetes and hypertension between January 2008 and January 2011 were enrolled from Fujian Provincial Hospital. 235 patients were assigned into intensive systolic blood pressure (SBP) control group (130-139 mm Hg, 1 mm Hg=0.133 kPa), while 472 patients were assigned into non-intensive SBP control group(140-159 mm Hg). Both groups maintained their SBP level for at least 3 years. All of subjects underwent 12-lead electrocardiogram, and the voltage of R wave in lead aVL(RaVL) was used to estimate the risk of cardiovascular disease. Estimated glomerular filtration rate (eGFR) was estimated by Cockcroft-Gault formula for evaluation the renal function. Multivariate logistic regression analysis was used while RaVL≥0.57 mV and RaVL<0.57 mV as the dependent variable. Results The level of RaVL in intensive SBP control group and non-intensive SBP control group was 0.55(0.50-0.59), 0.58(0.52-0.64) mV, respectively. The difference between the two groups was not statistically significant(F=0.235, P>0.05). The value of eGFR in intensive SBP control group and non-intensive SBP control group was 59.6(56.2-63.1), 55.6(53.2-58.0) ml/min, respectively. The difference was also not statistically significant(F=1.289, P>0.05). Multivariate logistic regression analysis showed that the risk of non-intensive SBP control group was not higher than intensive SBP control group(OR=0.927, 95%CI: 0.567-1.514, P>0.05). Conclusion SBP below 140 mm Hg may not reduce cardiovascular and chronic renal disease risk in elderly patients with type 2 diabetes and hypertension. Key words: Diabetes mellitus, type 2; Hypertension; Elderly patients; Cardiovascular disease