{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T18:28:30Z","timestamp":1779301710271,"version":"3.51.4"},"reference-count":58,"publisher":"American Diabetes Association","issue":"6","license":[{"start":{"date-parts":[[2018,5,21]],"date-time":"2018-05-21T00:00:00Z","timestamp":1526860800000},"content-version":"vor","delay-in-days":54,"URL":"http:\/\/www.diabetesjournals.org\/content\/license"}],"funder":[{"DOI":"10.13039\/501100005407","name":"Food and Health Bureau","doi-asserted-by":"publisher","award":["EPC-HKU-2"],"award-info":[{"award-number":["EPC-HKU-2"]}],"id":[{"id":"10.13039\/501100005407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["diabetesjournals.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,6,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE<\/jats:title>\n                  <jats:p>The objective of this study was to compare the incidence of cardiovascular disease (CVD) among patients with type 2 diabetes mellitus (T2DM) with treated hypertension who achieved systolic blood pressures (SBPs) of &amp;lt;120, &amp;lt;130, and &amp;lt;140 mmHg after an increase in their antihypertensive regimen.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESEARCH DESIGN AND METHODS<\/jats:title>\n                  <jats:p>A retrospective cohort study was conducted on 28,014 primary care adult patients with T2DM with no prior diagnosis of CVD and who achieved SBP readings &amp;lt;140 mmHg after an increase in the number of antihypertensive medications prescribed. Using an extension of propensity score matching, a total of 2,079, 10,851, and 15,084 matched patients with achieved SBP measurements of &amp;lt;120, &amp;lt;130, and &amp;lt;140 mmHg were identified. The association between achieved SBP and incident CVD were evaluated using Cox regressions. Subgroup analyses were conducted by stratifying patients\u2019 baseline characteristics.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Over a median follow-up period of 4.8 years, the incidence of CVD in patients with achieved SBP measures of &amp;lt;120, &amp;lt;130, and &amp;lt;140 mmHg were 318 (15.3%; incidence rate [IR] 34.3\/1,000 person-years [PY]), 992 (9.1%; IR 20.4\/1,000 PY), and 1,635 (10.8%; IR 21.4\/1,000 PY). Achieved SBP &amp;lt;120 mmHg was associated with a higher risk of CVD compared with achieved SBP &amp;lt;130 mmHg (hazard ratio [HR] 1.75 [95% CI 1.53, 2.00]) and achieved SBP &amp;lt;140 mmHg (HR 1.67 [95% CI 1.46, 1.90]). There was a significant reduction in CVD risk in patients &amp;lt;65 years (HR 0.81 [95% CI 0.69, 0.96]) but no difference for other patients, including patients \u226565 years, who achieved SBP &amp;lt;130 mmHg when compared with the group that achieved SBP &amp;lt;140 mmHg.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>Our findings support a SBP treatment target of 140 mmHg and suspect no risk reduction attenuation on CVD for lower SBP targets (&amp;lt;120 or &amp;lt;130 mmHg) for most patients with uncomplicated T2DM. A randomized control trial is still needed to confirm these findings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2337\/dc17-2443","type":"journal-article","created":{"date-parts":[[2018,3,28]],"date-time":"2018-03-28T13:45:28Z","timestamp":1522244728000},"page":"1134-1141","update-policy":"https:\/\/doi.org\/10.2337\/ada-journal-policies","source":"Crossref","is-referenced-by-count":27,"title":["Effect of Achieved Systolic Blood Pressure on Cardiovascular Outcomes in Patients With Type 2 Diabetes: A Population-Based Retrospective Cohort Study"],"prefix":"10.2337","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6275-1147","authenticated-orcid":false,"given":"Eric Yuk Fai","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther Yee Tak","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weng Yee","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6073-2516","authenticated-orcid":false,"given":"Colman Siu Cheung","family":"Fung","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Yee Tak","family":"Fong","sequence":"additional","affiliation":[{"name":"School of Nursing, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edmond Pui Hang","family":"Choi","sequence":"additional","affiliation":[{"name":"School of Nursing, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anca Ka Chun","family":"Chan","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy Lo Kuen","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1167","published-online":{"date-parts":[[2018,3,28]]},"reference":[{"key":"2022031301170726000_B1","first-page":"e146","article-title":"Heart disease and stroke statistics-2017 update: a report from the American Heart Association [published correction appears in Circulation 2017;135:e646; 136:e196]","volume":"135","author":"Benjamin","year":"2017","journal-title":"Circulation"},{"key":"2022031301170726000_B2","volume-title":"IDF Diabetes Atlas","author":"International Diabetes Federation","year":"2015","edition":"7th ed"},{"key":"2022031301170726000_B3","doi-asserted-by":"crossref","first-page":"15019","DOI":"10.1038\/nrdp.2015.19","article-title":"Type 2 diabetes mellitus","volume":"1","author":"DeFronzo","year":"2015","journal-title":"Nat Rev Dis Primers"},{"key":"2022031301170726000_B4","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1016\/j.ecl.2013.09.005","article-title":"Type 2 diabetes mellitus and hypertension: an update","volume":"43","author":"Lastra","year":"2014","journal-title":"Endocrinol Metab Clin North Am"},{"key":"2022031301170726000_B5","first-page":"891","article-title":"Cardiovascular outcomes in Framingham participants with diabetes: the importance of blood pressure.","volume-title":"Hypertension","author":"Chen","year":"2011"},{"key":"2022031301170726000_B6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.diabres.2012.10.001","article-title":"Global guideline for type 2 diabetes","volume":"104","author":"International Diabetes Federation Guideline Development Group","year":"2014","journal-title":"Diabetes Res Clin Pract"},{"key":"2022031301170726000_B7","unstructured":"Department of Health, HKSAR. 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