Toshiko Takao1, Kumiko Kimura2, Machi Suka3, Hiroyuki Yanagisawa3, Masatoshi Kikuchi2, Shoji Kawazu2, Yutaka Matsuyama4. 1. Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan. Electronic address: t-takao@asahi-life.or.jp. 2. Division of Diabetes and Metabolism, The Institute for Adult Diseases, Asahi Life Foundation, Tokyo, Japan. 3. Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo, Japan. 4. Department of Biostatistics, School of Public Health, University of Tokyo, Tokyo, Japan.
Abstract
AIMS: To determine whether visit-to-visit blood pressure (BP) variability can predict cardiovascular disease (CVD) incidence in type 2 diabetes patients independently of mean BP, and to analyze the time-to-effect relationship between BP and CVD risk. METHODS: We retrospectively enrolled 629 type 2 diabetes patients with no history of CVD who first visited our hospital between 1995 and 1996, made at least one hospital visit per year, were followed-up for at least 1 year, and had undergone four or more BP measurements. The patients were followed until June 2012 at the latest. RESULTS: CVD occurred in 66 patients. Variability in systolic or diastolic BP (SBP and DBP, respectively) was a significant predictor of CVD incidence, independent of mean SBP or DBP. CVD incidence was significantly associated with SBP during the preceding 3-5 years, with the highest risk occurring during the preceding 3 years. CONCLUSIONS: Visit-to-visit BP variability independently predicts CVD incidence in type 2 diabetes patients. Increased SBP over the preceding 3-5 years indicated a significant CVD risk. To prevent CVD, BP management should focus on stable and well-timed control. In particular, BP stabilization at an early phase and BP control during late phases are important.
AIMS: To determine whether visit-to-visit blood pressure (BP) variability can predict cardiovascular disease (CVD) incidence in type 2 diabetespatients independently of mean BP, and to analyze the time-to-effect relationship between BP and CVD risk. METHODS: We retrospectively enrolled 629 type 2 diabetespatients with no history of CVD who first visited our hospital between 1995 and 1996, made at least one hospital visit per year, were followed-up for at least 1 year, and had undergone four or more BP measurements. The patients were followed until June 2012 at the latest. RESULTS: CVD occurred in 66 patients. Variability in systolic or diastolic BP (SBP and DBP, respectively) was a significant predictor of CVD incidence, independent of mean SBP or DBP. CVD incidence was significantly associated with SBP during the preceding 3-5 years, with the highest risk occurring during the preceding 3 years. CONCLUSIONS: Visit-to-visit BP variability independently predicts CVD incidence in type 2 diabetespatients. Increased SBP over the preceding 3-5 years indicated a significant CVD risk. To prevent CVD, BP management should focus on stable and well-timed control. In particular, BP stabilization at an early phase and BP control during late phases are important.
Authors: 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 Journal: Diabetes Metab J Date: 2019-03-06 Impact factor: 5.376
Authors: Katy J L Bell; Lamiae Azizi; Peter M Nilsson; Andrew Hayen; Les Irwig; Carl J Östgren; Johan Sundröm Journal: PLoS One Date: 2018-04-11 Impact factor: 3.240