title: Blood pressure and risk of cardiovascular diseases in type 2 diabetes:  further findings from the Swedish National Diabetes Register (NDR-BP II).
abstract: OBJECTIVE
  Estimate risks of coronary heart disease (CHD), stroke and cardiovascular disease (CVD) with updated mean systolic (SBP) and diastolic (DBP) blood pressure in an observational study of patients with type 2 diabetes.
  
  
  METHODS
  Thirty-five thousand and forty-one patients treated with antihypertensive drugs, and 18 512 untreated patients, aged 30-75 years, without previous heart failure, followed for 6 years until 2009.
  
  
  RESULTS
  In treated patients, nonlinear splines for 6-year risk of fatal/nonfatal CHD, stroke and CVD by BP as a continuous variable showed a progressive increase with higher SBP from 140  mmHg and higher, and with DBP from 80  mmHg, with a J-shaped risk curve at lowest SBP levels, but not obviously at lowest DBP levels. Analysing intervals of SBP with 130-134  mmHg as reference at Cox regression, adjusted hazard ratios (HR) for fatal/nonfatal CHD, stroke and CVD with at least 140  mmHg were 1.22 [95% confidence interval (CI): 1.08-1.39], 1.43 (1.18-1.72), 1.26 (1.13-1.41), all P < 0.001. HR with 115-129 and 135-139  mmHg were nonsignificant, whereas increased with 100-114  mmHg, 1.96 (P < 0.001), 1.75 (P = 0.02), 2.08 (P < 0.001), respectively. With DBP 75-79  mmHg as reference, adjusted HR for fatal/nonfatal CHD, stroke and CVD with DBP 80-84  mmHg were 1.42 (1.26-1.59), 1.46 (1.24-1.72), 1.39 (1.26-1.53), all P < 0.001. Corresponding HR with DBP at least 85  mmHg were 1.70 (1.50-1.92), 2.35 (1.99-2.77), 1.87 (1.69-2.07), all P < 0.001. Corresponding HR with DBP 60-69 and 70-74  mmHg were nonsignificant. The picture was similar in 7059 patients with previous CVD and in untreated patients.
  
  
  CONCLUSIONS
  BP around 130-135/75-79  mmHg showed lower risks of cardiovascular diseases in patients with type 2 diabetes.
authors.affiliation: Department of Public Health and Caring Sciences/Family Medicine and Clinical Epidemiology, Uppsala University, Uppsala, Sweden.
authors.forename: Jan
authors.initials: J
authors.lastname: Cederholm
authors.forename: Soffia
authors.initials: S
authors.lastname: Gudbjörnsdottir
authors.forename: Björn
authors.initials: B
authors.lastname: Eliasson
authors.forename: Björn
authors.initials: B
authors.lastname: Zethelius
authors.forename: Katarina
authors.initials: K
authors.lastname: Eeg-Olofsson
authors.forename: Peter M
authors.initials: PM
authors.lastname: Nilsson
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000150:complications* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D013548:Sweden