title: Lower blood pressure associated with higher mortality in elderly diabetic patients (ZODIAC-12).
abstract: OBJECTIVE
  to investigate the relationship between blood pressure over time and mortality in elderly patients with type 2 diabetes mellitus (T2DM).
  
  
  METHODS
  prospective observational cohort study.
  
  
  METHODS
  primary care, Zwolle, The Netherlands.
  
  
  METHODS
  patients with T2DM aged 60 years and older (n = 881). The cohort was divided into two age categories: 60-75 years and older than 75 years.
  
  
  METHODS
  updated means for systolic, diastolic and pulse pressures were calculated after a median follow-up time of 9.8 years. These values were used as time-dependent covariates in a Cox proportional hazard model. Main outcome measures were all-cause and cardiovascular mortality.
  
  
  RESULTS
  all of the blood pressure measures were inversely related to all-cause mortality in elderly diabetic patients (>75 years). Furthermore, these relationships were specifically found in elderly patients treated with antihypertensive medication at baseline. A decrease of 10 mm Hg in systolic blood pressure, diastolic blood pressure and pulse pressure led to a mortality increase of 22% [95% confidence interval (95% CI): 13-31%], 30% [95% CI: 13%-46%] and 22% [95% CI: 11%-33%], respectively. In the low age group (60-75 years), no relationship was found between blood pressure and mortality.
  
  
  CONCLUSIONS
  blood pressure is a marker for mortality in elderly T2DM patients; however, the relationship is inverse.
authors.affiliation: Diabetes Centre, Isala Clinics, Zwolle, The Netherlands. k.j.j.van.hateren@isala.nl
authors.forename: Kornelis J J
authors.initials: KJ
authors.lastname: van Hateren
authors.forename: Gijs W D
authors.initials: GW
authors.lastname: Landman
authors.forename: Nanne
authors.initials: N
authors.lastname: Kleefstra
authors.forename: Klaas H
authors.initials: KH
authors.lastname: Groenier
authors.forename: Adriaan M
authors.initials: AM
authors.lastname: Kamper
authors.forename: Sebastiaan T
authors.initials: ST
authors.lastname: Houweling
authors.forename: Henk J G
authors.initials: HJ
authors.lastname: Bilo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D003924:Diabetes Mellitus, Type 2 / Q000401:mortality*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents