{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:35:30Z","timestamp":1758818130105},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2012,9,24]],"date-time":"2012-09-24T00:00:00Z","timestamp":1348444800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Intern Med"],"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Hypertension and proteinuria are major risk factors for cardiovascular disease (<jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>) mortality in patients with type 2 diabetes. Blood pressure (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>) targets have been progressively lowered in these patients to prevent or delay the progression of nephropathy. However, no long\u2010term population\u2010based studies have been reported on the interaction between <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> and proteinuria with respect to total and <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> mortality in patients with type 2 diabetes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>We prospectively followed 881 middle\u2010aged type 2 diabetic patients, free of <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> events at baseline, for up to 18\u00a0years. Participants were categorized into four groups according to baseline systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> (&lt;130, 130\u2013139, 140\u2013159 and \u2265160\u00a0mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g) and further stratified by proteinuria (\u2264150 or &gt;150\u00a0mg\u00a0L<jats:sup>\u22121<\/jats:sup>). Cox proportional hazards model was used to estimate the joint association between systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> and proteinuria and the risk of mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During follow\u2010up, 607 patients died including 395 because of <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content>. After adjustment for confounding factors, total and <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> mortality were significantly higher in patients with proteinuria and systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> &lt;130\u00a0mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g compared with those with systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> between 130 and 160\u00a0mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g. The prognosis was similar in patients with systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> &lt;130\u00a0mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g or \u2265160\u00a0mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g. Among patients without proteinuria, systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> &lt;130\u00a0mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g was associated with a nonsignificant reduction in mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Type 2 diabetic patients with proteinuria and with systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> &lt;130\u00a0mm<jats:styled-content style=\"fixed-case\">H<\/jats:styled-content>g may have an increased risk of <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> mortality. The presence of proteinuria should be taken into account when defining the target systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> level for the prevention of fatal <jats:styled-content style=\"fixed-case\">CVD<\/jats:styled-content> events in patients with type 2 diabetes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2796.2012.02581.x","type":"journal-article","created":{"date-parts":[[2013,4,12]],"date-time":"2013-04-12T13:45:28Z","timestamp":1365774328000},"page":"611-619","source":"Crossref","is-referenced-by-count":8,"title":["Proteinuria modifies the effect of systolic blood pressure on total and cardiovascular disease mortality in patients with type 2 diabetes"],"prefix":"10.1111","volume":"272","author":[{"given":"T.","family":"Veps\u00e4l\u00e4inen","sequence":"first","affiliation":[{"name":"Department of Medicine Turku University Hospital University of Turku Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Laakso","sequence":"additional","affiliation":[{"name":"Department of Medicine Kuopio University Hospital University of Eastern Finland Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Kantola","sequence":"additional","affiliation":[{"name":"Department of Medicine Turku University Hospital University of Turku Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Lehto","sequence":"additional","affiliation":[{"name":"Department of Medicine Kuopio University Hospital University of Eastern Finland Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Juutilainen","sequence":"additional","affiliation":[{"name":"Department of Medicine Kuopio University Hospital University of Eastern Finland Kuopio Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"R\u00f6nnemaa","sequence":"additional","affiliation":[{"name":"Department of Medicine Turku University Hospital University of Turku Turku Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,9,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)60484-9"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7134.823"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.27.11.2033"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11906-005-0045-9"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021778"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.11.6.449"},{"key":"e_1_2_6_8_1","volume-title":"Cardiovascular Survey Methods","author":"Rose G","year":"1982"},{"key":"e_1_2_6_9_1","volume-title":"Proposal for the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease and Protocol (MONICA project)","author":"World Health Organization","year":"1983"},{"key":"e_1_2_6_10_1","first-page":"I13","article-title":"The national survey of stroke. 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