Key result
Higher visit-to-visit variability of systolic blood pressure was associated with an increased risk of cardiovascular disease (HR 1.24) compared to the lowest quintile in patients with type 2 diabetes.
Why the study?
Increasing evidence links visit-to-visit blood pressure variability to cardiovascular disease, but its impact among patients with type 2 diabetes mellitus in China required evaluation.
Does higher visit-to-visit variability of blood pressure increase the risk of cardiovascular disease in patients with type 2 diabetes mellitus?
Cohort (n=10,163)
Yes
Does higher visit-to-visit variability of blood pressure increase the risk of cardiovascular disease in patients with type 2 diabetes mellitus?
Hazard Ratio: 1.24 (95% CI 1.01–1.52)
Absolute Event Rate: 13.7% vs 8%
p-value: p=<0.001
Higher visit-to-visit variability of systolic blood pressure is associated with an increased risk of cardiovascular disease in patients with type 2 diabetes, independent of mean SBP levels.
BP VVV may raise CVD risk in T2DM; leaves open whether targeting variability improves outcomes.
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.
No takes yet. Share an insight, caveat, or question.
Yu et al. (2019) conducted a cohort in Type 2 Diabetes Mellitus (n=10,163). High visit-to-visit variability of systolic blood pressure (highest quintile of standard deviation) vs. Low visit-to-visit variability of systolic blood pressure (lowest quintile of standard deviation) was evaluated on Cardiovascular disease events (myocardial infarction and cerebrovascular disease) (HR 1.24, 95% CI 1.01-1.52, p=<0.001). Higher visit-to-visit variability of systolic blood pressure was associated with an increased risk of cardiovascular disease (HR 1.24) compared to the lowest quintile in patients with type 2 diabetes.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: