High blood pressure and high glucose levels present a comparable risk for young adults with type 1 diabetes to develop heart disease

SAN FRANCISCO, June 8, 2019 / PRNewswire / – Hypertension and hyperglycemia represent a similar risk of developing heart disease in young adults with type 1 diabetes (T1D), the risk of heart disease doubling when blood pressure is greater than or equal to 120/80 mmHg, according to the study "Optimal Objectives of Blood Pressure for Cardiovascular Health in People with Type 1 Diabetes", presented today at the American Diabetes Association^® (79th Scientific Sessions of the ADA)^® at the Moscone Convention Center San Francisco.

The Pittsburgh Diabetes Complications Epidemiology (EDC) study included T1D patients diagnosed at age 17 or younger and seen within one year of diagnosis at the Children's Hospital of Toronto. Pittsburgh between 1950 and 1980. This badysis was conducted for 25 years on 605 EDC participants without known coronary heart disease. It aimed to determine optimal blood pressure goals to minimize the risk of coronary artery disease.

The new aspect of this study is that time-weighted blood pressure measurements were created to comprehensively reflect long-term exposure to blood pressure. A dose-gradient badociation was observed between time-weighted systolic and diastolic blood pressure (PAS and DBP) levels, with mean arterial pressure (MAP) and risk of coronary artery disease, and the study showed that the optimal dosage (in terms of risk of lower coronary artery disease) the SBP, DBP and MAP levels were approximately 120, 80 and 90 mmHg, respectively.

Participants with blood pressure ≥ 120/80 mmHg, compared to <120/80 mmHg, were twice as likely to develop coronary artery disease. When participants were stratified into four categories based on time-weighted blood pressure (<or ≥ 120/80 mmHg) and time-weighted HbA1c (<or ≥ 8%), compared to participants meeting the blood pressure (<120/80 mmHg) and HbA1c (<8%) targets, the hypertensive group only had a similar risk (HR: 2.0 [1.1, 3.9]) compared to the group only rich in HbA1c (HR: 1.6 [0.97, 2.8]). These results confirm that the optimal cardiovascular risk reduction goals in young adults with T1D below the current recommendation of 140/90 mmHg for blood pressure could be beneficial. Decreasing blood pressure and achieving glycemic goals can further reduce cardiovascular risk in these individuals, improving long-term outcomes and reducing additional serious complications of T1D.

"Our researchers have been intrigued by the findings suggesting that blood pressure and blood sugar are equally important for predicting cardiovascular risk in this group of patients with type 1 diabetes," said the lead author of the study. Study, Jingchuan Guo, MD, PhD, postdoctoral fellow of the Center for Pharmaceutical Policy. Policy (CP3) at University of Pittsburgh. "Since blood pressure control is likely to be as important as glycemic control for the prevention of cardiovascular risk in people with type 1 diabetes, treatment should focus primarily on controlling blood glucose levels. when HbA1c is very high, but approaching the range of normal high values, increasing attention to blood pressure becomes critical. "

To speak with Dr. Guo, please contact the ADA Press Office on the Moscone Convention Center website at June 7-11, by phone at 415-978-3606 or by email at [email protected].

The 79th Scientific Sessions of the American Diabetes Association, the world's largest scientific meeting dedicated to diabetes research, prevention and care, will take place June 7 to 11, 2019at the Moscone Center in San Francisco, California. Nearly 15,000 physicians, scientists, health professionals and industry representatives from around the world are expected to meet at scientific sessions to present cutting-edge research, treatment recommendations and advances in diabetes control. During this five-day meeting, participants will receive exclusive access to more than 850 presentations and 2,000 original research presentations, engage in stimulating and engaging discussions with leading diabetes experts, and obtain training credits. Continuing Education (FMC) or Continuing Education (CE). for educational sessions. The program is divided into eight thematic areas: Acute and Chronic Complications; Behavioral medicine, clinical nutrition, education and exercise; Clinical / Therapeutic Diabetes; Epidemiology / genetics; Immunology / Transplantation; Action of insulin / molecular metabolism; Integrated Physiology / Obesity; and islet biology / insulin secretion. Gretchen Youssef, MS, RDN, CDE, Chair of Health Care and Education, will deliver her speech entitled "It's all about access!", The Saturday, June 8, and Louis H. Philipson, MD, PhD, FACP, President of Medicine and Science, will give his lecture entitled "Precision Medicine – Addressing the Multiple Facets of Diabetes", the Sunday, June 9. Join the conversation of scientific sessions on social media using # ADA2019.

About the American Diabetes Association
Every day, more than 4,000 people are diagnosed with diabetes in America. Nearly 115 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the country's leading volunteer health organization that fights to counter the diabetes epidemic and help people living with diabetes to flourish. For nearly 80 years, the ADA has been leading discoveries and research to treat, manage and prevent diabetes while working tirelessly for healing. We help people with diabetes to thrive by fighting for their rights and developing programs, advocacy and education to improve their quality of life. Diabetes has brought us together. What we do next will make us connected for life. For more information or to get involved, visit our website at diabete.org or call 1-800-DIABETES (1-800-342-2383). The information is available in English and Spanish. Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

Briefing: Changing concepts in type 1 diabetes, Sunday, June 9, 12:00 pm, PT

Session type: General session
Location: Poster Room (Room F, North, Exhibition Level)
Session time: Saturday, June 8, 2019, 11:30 – 12:30

Jingchuan GUO, RACHEL G. MILLERTINA COSTACOU, TREVOR J. ORCHARD, Pittsburgh, Pennsylvania

The study aimed to determine optimal blood pressure goals to minimize the risk of coronary artery disease in adults with early type 1 diabetes (T1D). Participants in the Pittsburgh Diabetes Complications Epidemiology Study who did not know a CAD database (n = 605) were recruited and followed for 25 years. Associations of cumulative (mmHg-year) and time-weighted (mmHg) measures of time-to-time updates [SBP]diastolic [DBP]and mean arterial pressure [MAP]) were examined using Cox proportional hazard models. The sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) were summarized by different time-weighted TA threshold points. Risk stratification badyzes were then undertaken based on time-weighted (<vs., ≥ 120/80 mmHg) and time-weighted HbA1c (<vs, ≥ 8%). All cumulative PA measures updated over time independently measure the CAD of the incident predicted over the follow-up period. A dose-gradient badociation was observed for time-weighted PAS, DBP and MAP categorized in their badociation with the risk of coronary artery disease. According to the Cox models and AUCs, the optimal cutoff points for PAS, DBP and MAP were about 120, 80 and 90 mmHg, respectively. Participants with BP ≥ 120/80 mm Hg, compared to <120/80 mm Hg, were badociated with a 1.9-fold increased risk of developing coronary artery disease. Compared with participants with good BP (<120/80 mmHg) and HbA1c (<8%) control, the only group with high BP (HR: 2.0) [1.1, 3.9]) had a similar risk compared to the only high-HbA1c group (HR: 1.6 [0.97, 2.8]). These results confirm that lower BP targets (ie, 120/80 mmHg) compared to the ADA 2018 guidelines (140/90 mmHg) may be needed for young adults with T1D. Lowering BP can further reduce cardiovascular risk in addition to maintaining good glycemic control in these individuals.

Block of disclosure of the author: J.Guo: No. R.G.Miller: No. T.Costacou: No. T.J.Orchard: Consultant; self; Boehringer Ingelheim International GmbH.

SOURCE American Diabetes Association

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http://www.diabetes.org