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Objective: to investigate the association between a decreased estimated glomerular filtration rate (eGFR), albuminuria and mortality in elderly patients with type 2 diabetes mellitus (T2DM).Design: prospective observational cohort study.Setting: primary care.Subjects: eight hundred and ten patients, ≥65 years with T2DM. Analyses were performed in age strata: 65–75 (n = 471), >75 (n = 339) years.Methods: Cox proportional hazard modelling was used to investigate the association between eGFR, albuminuria and all-cause and cardiovascular mortality after a median follow-up of 9.8 years.Results: an eGFR <45 and 45–60 ml/min/1.73 m2 is associated with increased cardiovascular mortality in patients of 65–75 years, hazard ratio (HR): 3.29 (1.58–6.86) and 1.78 (1.09–2.90), respectively; in those >75 years increased cardiovascular mortality was observed when eGFR was <45 ml/min/1.73 m2: 2.42 (1.47–3.69). Compared with patients of 65–75 years, an eGFR >60 ml/min/1.73 m2 and normo-albuminuria, fully adjusted HRs for cardiovascular mortality were 2.26 (1.04–4.92) and 4.86 (2.33–10.15) for those aged 65–75 years, an eGFR of 45–60 ml/min/1.73 m2 and normo-albuminuria or albuminuria, respectively; HRs were 1.33 (0.67–2.66) and 2.01 (1.02–3.94), respectively, for those >75 years.Conclusions: an eGFR of 45–60 ml/min/1.73 m2 in T2DM patients is associated with increased mortality in patients aged 65–75 years but not in those >75 years. Albuminuria is associated with increased mortality in patients >65 years. [ABSTRACT FROM AUTHOR]

Objective: to investigate the relationship between blood pressure over time and mortality in elderly patients with type 2 diabetes mellitus (T2DM). Design: prospective observational cohort study. Setting: primary care, Zwolle, The Netherlands. Subjects: patients with T2DM aged 60 years and older (n = 881). The cohort was divided into two age categories: 60-75 years and older than 75 years. Methods: updated means for systolic, diastolic and pulse pressures were calculated after a median follow-up time of 9.8 years. These values were used as time-dependent covariates in a Cox proportional hazard model. Main outcome measures were all-cause and cardiovascular mortality. Results: all of the blood pressure measures were inversely related to all-cause mortality in elderly diabetic patients (>75 years). Furthermore, these relationships were specifically found in elderly patients treated with antihypertensive medication at baseline. A decrease of 10mmHg in systolic blood pressure, diastolic blood pressure and pulse pressure led to a mortality increase of 20% [95% confidence interval (95% CI): 12-27%], 26% [95% CI: 12%-38%] and 20% [95% CI: 10%-29%], respectively. In the low age group (60-75 years), no relationship was found between blood pressure and mortality. Conclusions: blood pressure is a marker for mortality in elderly T2DM patients; however, the relationship is inverse. [ABSTRACT FROM AUTHOR]