Backgroud 众多的研究证实了由在有高血压和几研究的病人的控制也显示出的血压(Bp ) 减缓动脉粥样硬化的前进的有效性在在有类型 1 和类型 2 糖尿病的病人的颈动脉 intima 媒介厚度(CIMT ) 的减少的前进的集中的 glycemic 控制的功效。然而,很少研究在病人把 glycemic 对 Bp 控制的相对重要性与糖尿病和高血压作比较。我们试图与高血压在更老的病人调查在 Bp 和 glycemic 控制和无临床症状的颈动脉动脉粥样硬化之间的协会并且打 2 糖尿病。在代表性的研究的方法,颈动脉动脉的 B 模式高分辨率的 ultrasonography 60 年或在谁上在 670 个题目(508 男性和 162 女性) 被执行自我报导高血压而是冠的心疾病或击的没有历史。题目被他们的收缩血压分类:紧密的控制, < 130 mmHg;平常的控制, 130139 mmHg;或不受管束, 140 mmHg,并且由他们的血红素 A1c (HbA1c ) 水平:紧密的控制, <6.5% ;平常的控制, 6.5%7.5% ;或不受管束, 7.5% 分别地。结果吝啬的 CIMT 是 8.20 +/- 0.11 公里,和颈动脉匾在 52.5% 被发现(352/670 ) 题目。总的来说, 62.1% 题目有无临床症状的颈动脉动脉粥样硬化,定义为有任何一个颈动脉匾或提高了 CIMT (1.1 公里) 。吝啬的 CIMT 在 Bp 控制范畴之间是显著地不同的( 7.60 +/- 0.09 公里, 7.90 +/- 0.08 公里,和 8.60 +/- 0.12 公里,分别地 P = 0.03 )然而并非在 glycemic 控制范畴之间( 8.20 +/- 0.10 公里, 8.1 +/- 0.08 公里,和 8.40 +/- 0.14 公里,分别地, P = 0.13 )用 ANCOVA 分析。 Multivariable 逻辑回归为使因素惊讶的潜力调整证明平常或不受管束的 Bp 控制与有颈动脉匾被联系(或= 1.08 并且或= 1.42 ,分别地),或提高的 CIMT [奇怪的比率(或)= 1.17 ,95%信心间隔( CI ) 1.042.24 ,并且或= 1.54 ,95% CI 1.362.96 ,分别地与紧密的 Bp 控制相比;但是表演 glycemic 没控制有的任何一个的同样独立的?
Backgroud Numerous studies have confirmed the effectiveness of slowing the progression of atherosclerosis by blood pressure (Bp) control in patients with hypertension and several studies also showed the efficacy of intensive glycemic control in decreasing progression of carotid intima-media thickness (CIMT) in patients with type 1 and type 2 diabetes. However, few studies have compared the relative importance of glycemic w'. Bp control in patients with diabetes and hypertension. We aimed to investigate the association between Bp and glycemic control and subclinical carotid atherosclerosis in older patients with hypertension and type 2 diabetes. Methods In a cross-sectional study, B-mode high-resolution ultrasonography of the carotid artery was performed in 670 subjects (508 males and 162 females) aged 60 years or over who had self-reported hypertension and diabetes but no history of coronary heart disease or stroke. Subjects were categorized by their systolic blood pressure: tight control, 〈 130 mmHg; usual control, 130-139 mmHg; or uncontrolled, 〉 140 mmHg, and by their hemoglobin Alc (HbAlc) level: tight control, 〈 6.5%; usual control, 6.5%-7.5%; or uncontrolled, 〉 7.5%, respectively. Results The mean CIMT was 8.20 ±0.11 mm, and carotid plaque was found in 52.5% (352/670) subjects. Overall, 62.1% of the subjects had subclinical carotid atherosclerosis, defined as having either carotid plaque or elevated CIMT (≥ 1.1 ram). The mean CIMT was significantly different between Bp control categories (7.60 ± 0.09 mm, 7.90 ±0.08 mm, and 8.60 ± 0.12 mm, respectively, P = 0.03) but not between glycemic control categories (8.20± 0.10 mm, 8.1 ±0.08 mm, and 8.40 ± 0.14 ram, respectively, P = 0.13) using ANCOVA analysis. Multivariable logistic regression adjusting for potential confounding factors showed that usual or uncontrolled Bp control were associated with having carotid plaque (OR = 1.08 and OR=1.42, respectively), or elevated CIMT [Odd ratio (OR) = 1.17, 95