Systolic blood pressure as a predictor for cardiovascular disease in diabetes. A 5-year longitudinal study.

Diabetic patients suffer from atherosclerotic diseases more often and at an earlier stage than nondiabetic persons. The factors predisposing those with diabetes to premature arteriosclerosis are not fully clarified. Data from a 5-year follow-up of 615 diabetic outpatients of the Schwabing Study are reported. Forty-six (8.5%) died from a cardiovascular cause of death, 13 (2.4%) suffered from stroke, 68 (12.5%) showed electrocardiographic changes indicative of significant coronary heart disease, and 11 (2.0%) exhibited an ischemic foot lesion. Univariate and multiple logistic analyses of baseline variables revealed systolic blood pressure as the most consistent risk factor for these events. The frequency of major cardiovascular events was as high in men as in women. It is concluded that systolic blood pressure has been seriously underestimated as a predictor for macrovascular events.