The effect of cardiovascular–kidney–metabolic disease on pulse pressure in patients with type II diabetes

Abstract: CONTEXT: Cardiovascular–kidney–metabolic (CKM) syndrome is a complex condition arising from interrelated factors such as heart disease, diabetes mellitus (DM), kidney dysfunction, and obesity. These factors may cause multiple organ failure, thus impacting patient’s health. AIMS: The aim of this study was to explore the association between CKM risk factors, such as estimated glomerular filtration rate, blood pressure, albumin-creatinine ratio, age, body mass index (BMI), low-density lipoprotein cholesterol, glycated hemoglobin (HbA1c), and pulse pressure (PP) in patients with type 2 DM (T2DM). METHODOLOGY: Retrospective, cross-sectional study conducted using 32,333 T2DM patients’ data from Diamond database at a single center. Multivariate regression analysis assessed the relationship between PP and associated CKM risk factors. RESULTS: The analysis revealed significant positive correlations between PP and age ( r = 0.412), BMI ( r = 0.019), albuminuria ( r = 0.092), and HbA1c levels ( r = 0.115). The correlation between age and PP was found to be significant; a 1-year increase in age corresponded to a 0.474 mmHg rise in PP ( R 2 = 0.171; P < 0.001). CONCLUSIONS: PP, a crucial marker for cardiorenal disease in T2DM patients, can aid in determining the risk of developing CKM syndrome. Currently, strategies for identifying and managing CKM syndrome are not well defined, resulting in gaps in appropriate screening for metabolic risk factors, subclinical cardiovascular disease, and chronic kidney disease. However, assessment of these individual parameters and monitoring of PP can offer substantial benefits in the early detection and management of CKM syndrome, thereby improving patient outcomes.