Elevated blood pressure and glucose levels are both significant risk factors for heart disease in young adults with type 1 diabetes (T1D), a new long-term study concluded. The results of the study, â€śOptimal Blood Pressure Goals for Cardiovascular Health in Individuals with Type 1 Diabetes,â€ť were presented at the American Diabetes Associationâ€™s (ADAâ€™s) 79th Scientific Sessions at the Moscone Convention Center in San Francisco.
The study included 605 T1D patients who were diagnosed at age â‰¤ 17 years; patients were followed for 25 years. Patients with elevated blood pressure levels (â‰Ą 120/80 mm Hg) were twice as likely to develop coronary artery disease (CAD) compared to patients with blood pressure < 120/80 mm Hg.
Patients were stratified by time-weighted blood pressure (< or â‰Ą 120/80 mm Hg) and time-weighted HbA1c (< or â‰Ą 8%). Those with high blood pressure only had a hazard ratio (HR) of 2.0 for developing CAD, compared to an HR of 1.6 in the high HbA1c only group. Current guidelines recommend that young adults with T1D aim for a blood pressure level of 140/90 mm Hg. The findings of the present study suggest that even lower blood pressure levels may be beneficial for this patient population.
â€śOur researchers were intrigued by the findings suggesting that blood pressure and glycemia are similarly important for cardiovascular risk prediction in this type 1 diabetes patient group,â€ť said lead study author Jingchuan Guo, MD, PhD, postdoctoral fellow at the Center for Pharmaceutical Policy and Policy at the University of Pittsburgh, in a meeting press release. â€śSince blood pressure control is likely to be as important as glucose control for cardiovascular risk prevention in people with type 1 diabetes, the initial treatment focus should be on glucose control, when HbA1c is very high, but as HbA1c approaches the high-normal range, an increasing focus on blood pressure becomes critical.â€ť