Effect of Variability in Blood Pressure, Glucose and Cholesterol Concentrations, and Body Weight on Emergency Hospitalization and 30‐Day Mortality in the General Population

Background Variability in blood pressure, glucose concentration, cholesterol concentration, or body weight is associated with a wide range of health outcomes. We hypothesized that high variability in metabolic parameters is associated with an increased risk of emergency hospitalization and mortality. Methods and Results Using a nationally representative database from the Korean National Health Insurance System, 8 049 228 individuals who underwent 3 or more health examinations during 2005 to 2010 were followed up until the end of 2016. Variability in fasting blood glucose and total cholesterol concentrations, systolic blood pressure, and body weight was measured using the variability independent of the mean (VIM). High variability was defined as the highest quartile of variability. Subjects were classified according to the number of high variability parameters. The end points of the study were emergency hospitalization and 30-day mortality. There were 733 387 emergency hospitalizations (9.1%) during a median follow-up of 5.6±1.2 years. For each metabolic parameter, an incrementally higher risk of emergency hospitalization was observed for higher VIM quartile groups than for the lowest quartile group. Compared with the group with low variability for all 4 parameters, the group with high variability for all 4 parameters had a significantly higher risk for emergency hospitalization (hazard ratio [HR], 1.58; 95% CI, 1.54-1.61) and 30-day mortality (HR, 2.44; 95% CI, 1.62-3.69), after adjusting for possible confounding factors. Conclusions High variability in metabolic parameters was associated with increased risk of emergency hospitalization and short-term mortality.