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Original Article
Epidemiology
Association of Visit-to-Visit Variability of Blood Pressure with Cardiovascular Disease among Type 2 Diabetes Mellitus Patients: A Cohort Study
Zhe-Bin Yu, Die Li, Xue-Yu Chen, Pei-Wen Zheng, Hong-Bo Lin, Meng-Ling Tang, Ming-Juan Jin, Jian-Bing Wang, Kun Chen
Diabetes Metab J. 2019;43(3):350-367.   Published online March 6, 2019
DOI: https://doi.org/10.4093/dmj.2018.0108
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  • 12 Web of Science
  • 12 Crossref
AbstractAbstract PDFSupplementary MaterialPubReader   
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.

Citations

Citations to this article as recorded by  
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    Primary Care Diabetes.2024; 18(4): 393.     CrossRef
  • Association between Variability of Metabolic Risk Factors and Cardiometabolic Outcomes
    Min Jeong Park, Kyung Mook Choi
    Diabetes & Metabolism Journal.2022; 46(1): 49.     CrossRef
  • Joint effect of blood pressure and glycemic variation on the risk of cardiovascular morbidity and mortality in persons with type 2 diabetes
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  • Visit‐to‐visit variability of blood pressure and risk of macrovascular and microvascular complications in patients with type 2 diabetes: A Chinese primary‐care cohort study
    Ying Deng, Yin Liu, Shengchao Zhang, Hanbing Yu, Xiaozhou Zeng, Rongrong An, Zhenyuan Chen, Na Sun, Xiaoxv Yin, Yue Dong
    Journal of Diabetes.2022; 14(11): 767.     CrossRef
  • Visit‑to‑visit blood pressure variability is associated with arterial stiffness in Chinese adults: A prospective analysis
    Yuwen Zhang, Lizhan Bie, Mian Li, Tiange Wang, Min Xu, Jieli Lu, Shuangyuan Wang, Jie Zhang, Yufang Bi, Weiqing Wang, Guang Ning, Yuhong Chen, Yu Xu
    The Journal of Clinical Hypertension.2021; 23(4): 802.     CrossRef
  • Variability of risk factors and diabetes complications
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    Cardiovascular Diabetology.2021;[Epub]     CrossRef
  • Effectiveness of statin intensive therapy in type 2 diabetes mellitus with high visit-to-visit blood pressure variability
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    Journal of Hypertension.2021; 39(7): 1435.     CrossRef
  • Prognostic importance of visit-to-visit blood pressure variability for micro- and macrovascular outcomes in patients with type 2 diabetes: The Rio de Janeiro Type 2 Diabetes Cohort Study
    Claudia R. L. Cardoso, Nathalie C. Leite, Gil F. Salles
    Cardiovascular Diabetology.2020;[Epub]     CrossRef
  • Impact of visit-to-visit variability in blood pressure on coronary plaque as assessed by integrated backscatter intravascular ultrasound
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  • VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND TARGET ORGAN DAMAGE IN RURAL DWELLERS WITH UNCOMPLICATED ARTERIAL HYPERTENSION
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  • HDL-Cholesterol, Its Variability, and the Risk of Diabetes: A Nationwide Population-Based Study
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    The Journal of Clinical Endocrinology & Metabolism.2019; 104(11): 5633.     CrossRef

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