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Central-to-brachial blood pressure amplification in type 2 diabetes: a systematic review and meta-analysis

Citation

Climie, RE and Schultz, MG and Fell, JW and Romero, L and Otahal, P and Sharman, JE, Central-to-brachial blood pressure amplification in type 2 diabetes: a systematic review and meta-analysis, Journal of Human Hypertension pp. 1-12. ISSN 0950-9240 (2018) [Refereed Article]


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Springer Nature Limited 2018 This post-print is subject to Springer Nature re-use terms https://www.nature.com/authors/policies/license.html#AAMtermsV1

DOI: doi:10.1038/s41371-018-0124-4

Abstract

Due to systolic blood pressure (SBP) amplification, brachial SBP may not accurately reflect central SBP, the pressure the organs are exposed to. Patients with type 2 diabetes (T2D) have vascular irregularities that may affect blood pressure (BP) amplification and central BP indices (i.e. augmentation index [AIx] and augmentation pressure [AP]). By systematic review and meta-analysis, this study aimed firstly to determine the magnitude of central-to-brachial SBP and pulse pressure (PP) amplification in T2D compared to healthy controls and secondly, the difference in AIx and AP between the groups. Online databases were searched for published studies reporting invasive or non-invasive central and brachial SBP in T2D and healthy controls up to the 20th of February 2018. Random effects meta-analyses and meta-regression were used to analyze the studies. Eighteen studies (all non-invasive: 17 radial tonometry, 1 carotid tonometry, 2 brachial oscillometry) with a total of 2758 patients with T2D and 10,561 healthy controls were identified. There was no significant difference in SBP amplification between groups (T2D = 9.9  4.7, healthy controls = 9.6  4.5 mmHg, p = 0.84; pooled difference = 0.64 mmHg, 95%CI -0.27 1.54, p = 0.17) or PP amplification ratio (p = 0.16). However, among these studies, central BP indices (AIx corrected for heart rate and AP) were significantly higher in T2D (p < 0.05 for both). Despite a similar magnitude of central-to-brachial SBP amplification, patients with T2D have increased central systolic loading (AIx and AP) that cannot be discerned from brachial BP alone.

Item Details

Item Type:Refereed Article
Research Division:Medical and Health Sciences
Research Group:Cardiorespiratory Medicine and Haematology
Research Field:Cardiology (incl. Cardiovascular Diseases)
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Cardiovascular System and Diseases
UTAS Author:Climie, RE (Miss Rachel Climie)
UTAS Author:Schultz, MG (Dr Martin Schultz)
UTAS Author:Fell, JW (Associate Professor James Fell)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:129784
Year Published:2018
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2018-12-18
Last Modified:2019-09-10
Downloads:5 View Download Statistics

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