{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T12:23:49Z","timestamp":1771590229484,"version":"3.50.1"},"reference-count":45,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T00:00:00Z","timestamp":1655251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81941017"],"award-info":[{"award-number":["81941017"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81930021"],"award-info":[{"award-number":["81930021"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81970728"],"award-info":[{"award-number":["81970728"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["91857205"],"award-info":[{"award-number":["91857205"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82088102"],"award-info":[{"award-number":["82088102"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Municipal Education Commission\u2013Gaofeng Clinical Medicine"},{"DOI":"10.13039\/501100014137","name":"Shanghai Shenkang Hospital Development Center","doi-asserted-by":"publisher","award":["SHDC12019101"],"award-info":[{"award-number":["SHDC12019101"]}],"id":[{"id":"10.13039\/501100014137","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014137","name":"Shanghai Shenkang Hospital Development Center","doi-asserted-by":"publisher","award":["SHDC2020CR1001A"],"award-info":[{"award-number":["SHDC2020CR1001A"]}],"id":[{"id":"10.13039\/501100014137","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014137","name":"Shanghai Shenkang Hospital Development Center","doi-asserted-by":"publisher","award":["SHDC2020CR3064B"],"award-info":[{"award-number":["SHDC2020CR3064B"]}],"id":[{"id":"10.13039\/501100014137","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Jiao Tong University School of Medicine","award":["DLY201801"],"award-info":[{"award-number":["DLY201801"]}]},{"DOI":"10.13039\/501100018920","name":"Ruijin Hospital","doi-asserted-by":"publisher","award":["2018CR002"],"award-info":[{"award-number":["2018CR002"]}],"id":[{"id":"10.13039\/501100018920","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>The effect of lowering systolic blood pressure (SBP) on clinical outcomes in diabetic patients is controversial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We used 2-sample mendelian randomization (MR) to study the causal effect of decreasing SBP on the risk of macrovascular and microvascular outcomes in diabetic patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used 362 SBP-related genetic variants from a large genome-wide association study (n\u2005=\u2005299\u2005024) and UK Biobank (n\u2005=\u2005375\u2005256) as exposure. We evaluated 5 macrovascular and microvascular complications up to 60\u2005742 cases as outcomes in diabetes, including coronary artery disease (CAD), peripheral artery disease (PAD), nephropathy, retinopathy, and composite complications. All cases were diagnosed together with diabetes. We performed follow-up analyses by conducting 7 sensitivity analyses and comparing the present MR with results in general population, and clinical trials.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Genetic predisposition of each 10-mm Hg SBP decrease was significantly associated with a 28% decreased risk of CAD (odds ratio [OR]: 0.72; 95% CI, 0.59-0.89; P\u2005=\u2005.002), a 34% decreased risk of nephropathy (OR: 0.66; 95% CI, 0.54-0.81; P\u2005&amp;lt;\u2005.001), and a 34% decreased risk of the composite complications (OR: 0.66; 95% CI, 0.58-0.76; P\u2005&amp;lt;\u2005.001), and was nominally associated with a decreased risk of PAD (OR: 0.69; 95% CI, 0.48-0.99) and retinopathy (OR: 0.90; 95% CI, 0.81-0.99). The MR results in diabetes were similar with that in the general population and clinical trials.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>SBP lowering was causally associated with an attenuated risk of diabetic CAD and nephropathy. It provides genetic evidence for the beneficial effect of lifelong SBP control in preventing diabetes-related vascular outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgac354","type":"journal-article","created":{"date-parts":[[2022,6,15]],"date-time":"2022-06-15T14:38:55Z","timestamp":1655303935000},"page":"2616-2625","source":"Crossref","is-referenced-by-count":10,"title":["The Causal Effect of Systolic Blood Pressure Lowering on Vascular Outcomes in Diabetes: A Mendelian Randomization Study"],"prefix":"10.1210","volume":"107","author":[{"given":"Tianzhichao","family":"Hou","sequence":"first","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025 , China"},{"name":"Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mian","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025 , China"},{"name":"Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025 , 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Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4829-5915","authenticated-orcid":false,"given":"Yufang","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine , Shanghai 200025 , China"},{"name":"Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, State Key Laboratory of Medical Genomics, 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