Subject    :    [2019 June;43(3)] Association of Visit-to-Visit Variability of Blood Pressure with Cardiovascular Disease among Type 2 Diabetes Mellitus Patients: A Cohort Study
Writer KDA
Date 2019-06-28 17:26:54 Hit 1,677
LINK URL https://e-dmj.org/DOIx.php?id=10.4093/dmj.2018.0108 (Click 31)
Diabetes Metab J. 2019 Jun;43(3):350-367. English.
Published online Mar 06, 2019.  https://doi.org/10.4093/dmj.2018.0108 
Copyright © 2019 Korean Diabetes Association
   
Association of Visit-to-Visit Variability of Blood Pressure with Cardiovascular Disease among Type 2 Diabetes Mellitus Patients: A Cohort Study
Zhe-Bin Yu,1,* Die Li,1,* Xue-Yu Chen,1 Pei-Wen Zheng,1 Hong-Bo Lin,2 Meng-Ling Tang,1 Ming-Juan Jin,1 Jian-Bing Wang,1,3 and Kun Chen1,3
1Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, Hangzhou, China.
2Center for Disease Control and Prevention of Yinzhou District, Ningbo, China.
3Research Center for Air Pollution and Health, Zhejiang University, Hangzhou, China.

Corresponding author: Kun Chen. Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou 310058, China. Email: ck@zju.edu.cn Corresponding author: Jian-Bing Wang. Department of Epidemiology and Health Statistics, Zhejiang University School of Public Health, 866 Yuhangtang Road, Hangzhou 310058, China. Email: wangjianbing@zju.edu.cn

 

*Zhe-Bin Yu and Die Li contributed equally to this study as first authors.
 
Received June 29, 2018; Accepted October 08, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract

Background

Increasing evidence has shown that visit-to-visit variability (VVV) of blood pressure (BP) is associated with an increased risk of cardiovascular disease (CVD). The objective of this study was to evaluate the impact of VVV of systolic blood pressure (SBP) and diastolic blood pressure (DBP) on the risk of CVD among patients with type 2 diabetes mellitus (T2DM) in China.

Methods

We conducted a retrospective cohort study of 10,163 T2DM patients who were not previously diagnosed with CVD from January 2008 to December 2012 in Ningbo, China. The VVV of BP was calculated using five metrics, including standard deviation (SD), coefficient of variation (CV), variation independent of mean, average real variability, and successive variability (SV) of measurements, obtained over a 24-month measurement period. Hazard ratios and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression models for the associations of variability in BP with risk of CVD.

Results

A total of 894 CVD events were observed during a median follow-up of 49.5 months. The hazard ratio in the highest quintile of SD of SBP was 1.24 (95% CI, 1.01 to 1.52) compared with patients in the lowest quintile. The association between higher VVV of DBP and risk of CVD was not consistent across different metrics and sensitivity analyses.

Conclusion

Higher VVV of SBP was associated with an increased risk of CVD, irrespective of the mean SBP level. Future studies are needed to confirm these findings.

   
Keywords:
Blood pressureCardiovascular diseasesDiabetes mellitus, type 2
 

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