{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T03:52:46Z","timestamp":1787025166047,"version":"build-2736575974"},"reference-count":16,"publisher":"American Diabetes Association","issue":"1","license":[{"start":{"date-parts":[[2021,8,28]],"date-time":"2021-08-28T00:00:00Z","timestamp":1630108800000},"content-version":"vor","delay-in-days":3946,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/3.0\/"}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2011,1,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Blood pressure ranges associated with cardiovascular disease (CVD) events in advanced type 2 diabetes are not clear. Our objective was to determine whether baseline and follow-up (On-Study) systolic blood pressure (SBP), diastolic blood pressure (DBP), and SBP combined with DBP predict CVD events in the Veterans Affairs Diabetes Trial (VADT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                    <jats:p>Participants in the VADT (n = 1,791) with hypertension received stepped treatment to maintain blood pressure below the target of 130\/80 mmHg in standard and intensive glycemic treatment groups. Blood pressure levels of all subjects at baseline and On-Study were analyzed to detect associations with CVD risk. The primary outcome was the time from randomization to the first occurrence of myocardial infarction, stroke, congestive heart failure, surgery for vascular disease, inoperable coronary disease, amputation for ischemic gangrene, or CVD death.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Separated SBP \u2265140 mmHg had significant risk at baseline (hazards ratio [HR] 1.508, P &amp;lt; 0.001) and On-Study (HR 1.469, P = 0.002). DBP &amp;lt;70 mmHg increased CVD events at baseline (HR 1.482, P &amp;lt; 0.001) and On-Study (HR 1.491, P &amp;lt; 0.001). Combined blood pressure categories indicated high risk for CVD events for SBP \u2265140 with DBP &amp;lt;70 mmHg at baseline (HR 1.785, P = 0.03) and On-Study (HR 2.042, P = 0.003) and nearly all SBP with DBP &amp;lt;70 mmHg.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Increased risk of CVD events with SBP \u2265140 mmHg emphasizes the urgency for treatment of systolic hypertension. Increased risk with DBP &amp;lt;70 mmHg, even when combined with SBP in guideline-recommended target ranges, supports a new finding in patients with type 2 diabetes. The results emphasize that DBP &amp;lt;70 mmHg in these patients was associated with elevated CVD risk and may best be avoided.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2337\/dc10-1420","type":"journal-article","created":{"date-parts":[[2010,11,9]],"date-time":"2010-11-09T01:50:16Z","timestamp":1289267416000},"page":"34-38","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":78,"title":["Blood Pressure and Cardiovascular Disease Risk in the Veterans Affairs Diabetes Trial"],"prefix":"10.2337","volume":"34","author":[{"given":"Robert J.","family":"Anderson","sequence":"first","affiliation":[{"name":"Section of Endocrinology, VA Medical Center, Omaha, Nebraska;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gideon D.","family":"Bahn","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Coordinating Center, Hines VA Hospital, Hines, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas E.","family":"Moritz","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Coordinating Center, Hines VA Hospital, Hines, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derrick","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Cooperative Studies Program Coordinating Center, Hines VA Hospital, Hines, Illinois;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Abraira","sequence":"additional","affiliation":[{"name":"Research Service, VA Medical Center, Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Duckworth","sequence":"additional","affiliation":[{"name":"Section of Endocrinology, VA Medical Center, Phoenix, Arizona."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the VADT Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1167","published-online":{"date-parts":[[2010,11,8]]},"reference":[{"key":"2022031219101483700_B1","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1056\/NEJMoa0808431","article-title":"Glucose control and vascular complications in veterans with type 2 diabetes","volume":"360","author":"Duckworth","year":"2009","journal-title":"N Engl J Med"},{"key":"2022031219101483700_B2","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1056\/NEJMoa0802743","article-title":"Effects of intensive glucose lowering in type 2 diabetes","volume":"358","author":"Action to Control Cardiovascular Risk in Diabetes Study Group","year":"2008","journal-title":"N Engl J Med"},{"key":"2022031219101483700_B3","doi-asserted-by":"crossref","first-page":"2560","DOI":"10.1056\/NEJMoa0802987","article-title":"Intensive blood glucose control and vascular outcomes in patients with type 2 diabetes","volume":"358","author":"ADVANCE Collaborative Group","year":"2008","journal-title":"N Engl J Med"},{"key":"2022031219101483700_B4","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1136\/bmj.317.7160.703","article-title":"Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38","volume":"317","author":"UK Prospective Diabetes Study Group","year":"1998","journal-title":"BMJ"},{"key":"2022031219101483700_B5","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1016\/S0140-6736(98)07019-6","article-title":"Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)","volume":"352","author":"UK Prospective Diabetes Study Group","year":"1998","journal-title":"Lancet"},{"key":"2022031219101483700_B6","doi-asserted-by":"crossref","first-page":"1755","DOI":"10.1016\/S0140-6736(98)04311-6","article-title":"Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial","volume":"351","author":"Hansson","year":"1998","journal-title":"Lancet"},{"key":"2022031219101483700_B7","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1161\/01.CIR.0000049640.46039.52","article-title":"Intensive blood pressure control reduces the risk of cardiovascular events in patients with peripheral arterial disease and type 2 diabetes","volume":"107","author":"Mehler","year":"2003","journal-title":"Circulation"},{"key":"2022031219101483700_B8","first-page":"B54","article-title":"Effect of blood pressure control on diabetic microvascular complications in patients with hypertension and type 2 diabetes","volume":"23","author":"Estacio","year":"2000","journal-title":"Diabetes Care"},{"key":"2022031219101483700_B9","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.2337\/dc09-S013","article-title":"Standards of medical care in diabetes\u20142009","volume":"32","author":"American Diabetes Association","year":"2009","journal-title":"Diabetes Care"},{"key":"2022031219101483700_B10","doi-asserted-by":"crossref","first-page":"2560","DOI":"10.1001\/jama.289.19.2560","article-title":"The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report","volume":"289","author":"Chobanian","year":"2003","journal-title":"JAMA"},{"key":"2022031219101483700_B11","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1016\/S1056-8727(02)00277-5","article-title":"Design of the cooperative study on glycemic control and complications in diabetes mellitus type 2: Veterans Affairs Diabetes Trial","volume":"17","author":"Abraira","year":"2003","journal-title":"J Diabetes Complications"},{"key":"2022031219101483700_B12","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/0002-9343(84)90952-5","article-title":"Epidemiology of coronary heart disease: the Framingham study","volume":"76","author":"Castelli","year":"1984","journal-title":"Am J Med"},{"key":"2022031219101483700_B13","first-page":"1462","article-title":"2007 Guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC)","volume":"28","author":"Mancia","year":"2007","journal-title":"Eur Heart J"},{"key":"2022031219101483700_B14","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1161\/CIRCULATIONAHA.108.797936","article-title":"Single versus combined blood pressure components and risk for cardiovascular disease: the Framingham Heart Study","volume":"119","author":"Franklin","year":"2009","journal-title":"Circulation"},{"key":"2022031219101483700_B15","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1038\/ng.384","article-title":"Genome-wide association study of blood pressure and hypertension","volume":"41","author":"Levy","year":"2009","journal-title":"Nat Genet"},{"key":"2022031219101483700_B16","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1056\/NEJMoa0806359","article-title":"Long-term follow-up after tight control of blood pressure in type 2 diabetes","volume":"359","author":"Holman","year":"2008","journal-title":"N Engl J Med"}],"container-title":["Diabetes Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/34\/1\/34\/607348\/zdc00111000034.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/diabetesjournals.org\/care\/article-pdf\/34\/1\/34\/607348\/zdc00111000034.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,3,12]],"date-time":"2022-03-12T15:30:40Z","timestamp":1647099040000},"score":1,"resource":{"primary":{"URL":"https:\/\/diabetesjournals.org\/care\/article\/34\/1\/34\/27351\/Blood-Pressure-and-Cardiovascular-Disease-Risk-in"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,11,8]]},"references-count":16,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2010,11,8]]},"published-print":{"date-parts":[[2011,1,1]]}},"URL":"https:\/\/doi.org\/10.2337\/dc10-1420","relation":{},"ISSN":["0149-5992","1935-5548"],"issn-type":[{"value":"0149-5992","type":"print"},{"value":"1935-5548","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,11,8]]}}}