{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:30:44Z","timestamp":1790613044377,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T00:00:00Z","timestamp":1761609600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100020013","name":"NIHR Leicester Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020013","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Managing blood pressure (BP) in older adults with type 2 diabetes (T2D) and chronic kidney disease (CKD) remains controversial, particularly regarding optimal targets and the impact of inadequate monitoring. Using Clinical Practice Research Datalink (CPRD) data, this study assessed associations between baseline systolic and diastolic BP (SBP and DBP) and the risk of major adverse cardiovascular events (MACE) and mortality in adults aged \u226565 with both T2D and CKD, the impact of missing BP records (proxy for inadequate monitoring), and sex\u2010based differences in these relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted using CPRD data. The primary outcome was MACE (nonfatal stroke, myocardial infarction, and cardiovascular death); the secondary outcome was all\u2010cause mortality. Baseline BP was modelled continuously and categorised as high (\u2265140\/90\u2009mmHg), normal (&lt;140\/90\u2009mmHg), or missing (no BP record within 2\u2009years prior to diagnosis). Flexible parametric competing risks models estimated adjusted 5\u2010year outcome risks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>MACE analysis included 160\u2009764 individuals; mortality analysis included 181\u2009307. The 5\u2010year MACE risk was 14.1% for normal, 13.8% for high, and 19.6% for missing SBP. For all\u2010cause mortality, risks were 20.6% (normal), 19.4% (high), and 34.0% (missing). SBP was a stronger risk indicator than DBP for both outcomes. Lower SBP (120\u2009mmHg) was moderately associated with increased MACE and mortality; higher DBP (90\u2009mmHg) was linked to increased mortality. Men had higher MACE and mortality risks than women.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In older adults with T2D and CKD, lower SBP and DBP were moderately associated with a higher risk of MACE and mortality, but the strongest indicator of adverse outcomes was the absence of regular blood pressure monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70234","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T04:47:13Z","timestamp":1761713233000},"page":"593-605","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Blood pressure and adverse cardiovascular outcomes in older people with type 2 diabetes and chronic kidney disease: Findings based on the Clinical Practice Research Datalink databases in England"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9491-6110","authenticated-orcid":false,"given":"Anna","family":"Meffen","sequence":"first","affiliation":[{"name":"Leicester Real World Evidence Unit, Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2877-4342","authenticated-orcid":false,"given":"Freya","family":"Tyrer","sequence":"additional","affiliation":[{"name":"Leicester Real World Evidence Unit, Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junior","family":"Mbah Mbahnjeck","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2343-7099","authenticated-orcid":false,"given":"Kamlesh","family":"Khunti","sequence":"additional","affiliation":[{"name":"Leicester Real World Evidence Unit, Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Zaccardi","sequence":"additional","affiliation":[{"name":"Leicester Real World Evidence Unit, Diabetes Research Centre University of Leicester  Leicester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2625-0273","authenticated-orcid":false,"given":"Setor K.","family":"Kunutsor","sequence":"additional","affiliation":[{"name":"Leicester Real World Evidence Unit, Diabetes Research Centre University of Leicester  Leicester UK"},{"name":"Section of Cardiology, Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences University of Manitoba  Winnipeg Manitoba Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,28]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrendo.2017.151"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.10924"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021778"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.37.4.1053"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcd.2023.09.007"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.020999"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4070"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci17-0026"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afy053"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1511939"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaa028"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.33963\/KP.a2022.0297"},{"issue":"3","key":"e_1_2_9_14_1","first-page":"333","article-title":"Representation of blacks, women, and the very elderly (aged > or\u2009=\u200980) in 28 major randomized clinical trials","volume":"9","author":"Hall WD","year":"1999","journal-title":"Ethn Dis"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.019707"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae178"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.4093\/dmj.2017.0065"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2022.01.004"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYP.0000000000000232"},{"key":"e_1_2_9_20_1","unstructured":"Datalink CPR.Clinical Practice Research Datalink.2025. 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