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Dillinger JG, Patin C, Bonnin P, et al. Elevated BNP and High Brachial Pulse Pressure in Patients with Diabetes. Am J Hypertens. 2021;doi: 10.1093/ajh/hpab179.
Dillinger, J. G., Patin, C., Bonnin, P., Vidal-Trecan, T., Paven, E., Gautier, J. F., Riveline, J. P., Amah, G., & Henry, P. (2021). Elevated BNP and High Brachial Pulse Pressure in Patients with Diabetes. American journal of hypertension, . https://doi.org/10.1093/ajh/hpab179
Dillinger, Jean-Guillaume, et al. "Elevated BNP and High Brachial Pulse Pressure in Patients with Diabetes." American journal of hypertension vol. (2021). doi: https://doi.org/10.1093/ajh/hpab179
Dillinger JG, Patin C, Bonnin P, Vidal-Trecan T, Paven E, Gautier JF, Riveline JP, Amah G, Henry P. Elevated BNP and High Brachial Pulse Pressure in Patients with Diabetes. Am J Hypertens. 2021 Dec 30; doi: 10.1093/ajh/hpab179. Epub 2021 Dec 30. PMID: 34969077.
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Am J Hypertens. 2021 Dec 30; doi: 10.1093/ajh/hpab179. Epub 2021 Dec 30.

Elevated BNP and High Brachial Pulse Pressure in Patients with Diabetes.

American journal of hypertension

Jean-Guillaume Dillinger, Charlotte Patin, Philippe Bonnin, Tiphaine Vidal-Trecan, Elise Paven, Jean-François Gautier, Jean-Pierre Riveline, Guy Amah, Patrick Henry

Affiliations

  1. Université de Paris, AP-HP, hôpital Lariboisière, Département de Cardiologie, rue A Paré, Paris, France.
  2. Université de Paris, AP-HP, hôpital Lariboisière, Physiologie Clinique - Explorations Fonctionnelles, rue A Paré, Paris, France.
  3. Université de Paris, AP-HP, hôpital Lariboisière, Centre universitaire du diabète et de ses complications, rue A Paré, Paris, France.

PMID: 34969077 DOI: 10.1093/ajh/hpab179

Abstract

BACKGROUND: Heart failure (HF) is frequent in patients with diabetes mellitus (DM), and early detection improves prognosis. We investigated whether analysis of brachial blood pressure (BP) in daily practice can identify patients with DM and high risk for subsequent HF, as defined by brain natriuretic peptide (BNP) > 50 pg/ml.

METHODS: 3,367 Outpatients with DM without a history of cardiovascular disease were enrolled in a prospective study.

RESULTS: Age (mean±SD) was 56±14 years, 57% were male, 78% had type 2 DM and HbA1C was 7.4%±1.4%. A history of hypertension was recorded in 43% of patients and uncontrolled BP was observed in 13%. BNP concentration (mean±SD) was 21±21 ng/L and 9% of patients had high risk of incident HF. Brachial pulse pressure (PP) was the best BP parameter associated with high risk of incident HF compared to diastolic, systolic or mean BP (area under the ROC curve: 0.70, 0.65, 0.57 and 0.57 respectively). A multivariate analysis demonstrated that elevated PP was independently associated with high risk of incident HF (odds ratio [95%CI]: 2.1 [1.5-2.8] for PP ≥65mmHg). Study of central aortic BP and pulse wave velocity on 117 patients demonstrated that high risk of incident HF was associated with increased arterial stiffness and subendocardial ischemia. After a mean follow-up of 811days, elevated PP was associated with increased all-cause mortality (hazard ratio [95%CI]: 1.7 [1.1-2.8]).

CONCLUSIONS: Brachial PP is powerful and independent "easy to record" BP parameter associated with high risk of incident HF in diabetic patients.

© American Journal of Hypertension, Ltd 2021. All rights reserved. For Permissions, please email: [email protected].

Keywords: blood pressure; brain natriuretic peptide; diabetes mellitus; heart failure; mean blood pressure; pulse pressure

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