{"doi":"10.2337/dc24-2258","title":"Sex-Specific Blood Pressure Trajectories and Cardiovascular Disease in Type 1 Diabetes: 32-Year Follow-up of the Pittsburgh Epidemiology of Diabetes Complications Cohort","abstract":"OBJECTIVE: We examined sex differences in longitudinal blood pressure (BP) and 32-year cardiovascular disease (CVD) incidence in the Pittsburgh Epidemiology of Diabetes Complications type 1 diabetes cohort. RESEARCH DESIGN AND METHODS: BP was measured up to nine (median six) times between 1986-1988 baseline and 2016-2018; n = 300 women and 304 men without CVD at baseline were followed until December 2020 for incidence of total CVD, major adverse cardiovascular events (MACE) (CVD death, myocardial infarction [MI], or stroke), and hard coronary artery disease (hCAD) (CAD death, MI, or coronary revascularization/blockage ≥ 50%). We estimated associations between time to event and longitudinal systolic BP (SBP) and diastolic BP (DBP) by sex using joint models adjusted for time-varying longitudinal antihypertensive (AH) medication use, HbA1c, and overt nephropathy, baseline age, and other CVD risk factors. RESULTS: Longitudinal SBP was 5.8 mmHg lower (P < 0.0001) and DBP 6.2 mmHg lower (P < 0.0001) in women versus men. Women had -0.3 mmHg/year faster DBP decline (P < 0.0001) despite similar AH rates by sex. Incidence of CVD was similar by sex. Each 5-mmHg increment in longitudinal SBP (hazard ratio [HR] = 1.23; 95% CI 1.04, 1.45) and DBP (HR = 1.56; 95% CI 1.20, 2.04) was associated with MACE in men only; DBP (HR = 1.28; 95% CI 1.05, 1.56) was associated with hCAD in women only. CONCLUSIONS: BP was lower in women than men, and the strength of its association with the initial manifestation of CVD differed by sex. Further research into sex-specific BP mechanisms is needed to improve CVD risk reduction in people living with type 1 diabetes.","journal":"Diabetes Care","year":2025,"id":543074,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":22.178386323199504,"corpus_rank":9377,"citation_count":1,"citer_count":1,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.6835,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":309261,"name":"Trevor J. Orchard","orcid":"0000-0001-9552-3215","position":1,"is_corresponding":false},{"id":439760,"name":"Tina Costacou","orcid":"0000-0001-9303-3810","position":2,"is_corresponding":false},{"id":382894,"name":"Rachel G. Miller","orcid":"0000-0003-1845-8477","position":0,"is_corresponding":true}],"reference_count":37,"raw_metadata":null,"created_at":"2026-07-19T02:53:00.171379Z","pmid":"39932735","pmcid":"PMC11932817","fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}