title: Interaction between Mean Arterial Pressure and HbA1c in Prediction of Cardiovascular Disease Hospitalisation: A Population-Based Case-Control Study.
abstract: Objective. To explore the relationship between mean arterial pressure (MAP), HbA1c, and cardiovascular (CV) hospitalisation risk in type 2 diabetes. Design. Population-based case-control study. Settings. Primary and secondary care level in Cambridgeshire, United Kingdom. Participants. 588 patients with type 2 diabetes from 18 English general practices recording a CV hospitalisation in 2009-2011 were included. Risk-set sampling was used to select 2920 gender, age, and practice matched control type 2 diabetes patients. Main Outcome Measure. Conditional logistic regression was used to explore further dose-response relationships between MAP, HbA1c, and CV hospitalisation risk. Results. The relationship between MAP and CV hospitalisation was nonlinear (P < 0.001 for linearity test). The MAP associated with the lowest CV hospitalisation risk was 97 (95% CI: 93-101) mmHg. An interaction between MAP and HbA1c for increased risk of cardiovascular hospitalisation was observed among those with HbA1c < 7% (53 mmol/mol) and MAP < 97 mmHg. Conclusions. In type 2 diabetes, MAP is a good predictor of CV hospitalisation risk. CV hospitalisation is lowest with a MAP between 93 and 101 mmHg. CV hospitalisation was particularly high among those with both a low MAP and a lower HbA1c.
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China; Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele ST5 5BG, UK.
authors.forename: Dahai
authors.initials: D
authors.lastname: Yu
authors.affiliation: Department of Nephrology, The First Affiliated Hospital, Zhengzhou University, Zhengzhou 450052, China.
authors.forename: Zhanzheng
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Western Sydney University, Campbelltown, Sydney, NSW 2751, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Simmons
mesh_terms: D062186:Arterial Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D016022:Case-Control Studies; D016208:Databases, Factual; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000503:physiopathology*; D006442:Glycated Hemoglobin / Q000032:analysis*; D006760:Hospitalization; D006801:Humans; D008962:Models, Theoretical; D011237:Predictive Value of Tests
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human