Visit-to-visit variability in systolic blood pressure predicts development and progression of diabetic nephropathy, but not retinopathy, in patients with type 2 diabetes

Takao, Toshiko; Matsuyama, Yutaka; Yanagisawa, Hiroyuki; Kikuchi, Masatoshi; Kawazu, Shoji

doi:10.1016/j.jdiacomp.2013.11.003

Cited by 29 publications

(27 citation statements)

References 27 publications

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“…Full‐text versions of the remaining 73 articles were retrieved and singularly examined. Ultimately, 47 studies were excluded and, of the remaining 26 papers that were included, 22 were selected for quantitative analysis . Secondary endpoints (i.e.…”

Section: Resultsmentioning

confidence: 99%

Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes: A systematic review and meta‐analysis

Chiriacò

Pateras

Virdis

et al. 2019

Diabetes Obesity Metabolism

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Aim To investigate the associations of blood pressure variability (BPV), expressed as long‐term (visit‐to‐visit) and short‐term (ambulatory blood pressure monitoring [ABPM] and home blood pressure monitoring [HBPM]) and all‐cause mortality, major adverse cardiovascular events (MACEs), extended MACEs, microvascular complications (MiCs) and hypertension‐mediated organ damage (HMOD) in adult patients with type 2 diabetes. Materials and methods PubMed, Medline, Embase, Cinahl, Web of Science, http://clinicaltrials.gov and grey literature databases were searched for studies including patients with type 2 diabetes, at least one variable of BPV (visit‐to‐visit, HBPM, ABPM) and evaluation of the incidence of at least one of the following outcomes: all‐cause mortality, MACEs, extended MACEs and/or MiCs and/or HMOD. The extracted information was analyzed using random effects meta‐analysis and meta‐regression. Results Data from a total of 377 305 patients were analyzed. Systolic blood pressure (SBP) variability was associated with a significantly increased risk of all‐cause mortality (HR 1.12, 95% CI 1.04–1.21), MACEs (HR 1.01, 95% CI 1.04–1.17), extended MACEs (HR 1.07, 95% CI 1.03–1.11) and MiCs (HR 1. 12, 95% CI 1.01–1.24), while diastolic blood pressure was not. Associations were mainly driven from studies on long‐term SBP variability. Qualitative analysis showed that BPV was associated with the presence of HMOD expressed as carotid intima‐media thickness, pulse wave velocity and left ventricular hypertrophy. Results were independent of mean blood pressure, glycaemic control and serum creatinine levels. Conclusions Our results suggest that BPV might provide additional information rather than mean blood pressure on the risk of cardiovascular disease in patients with type 2 diabetes.

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Section: Resultsmentioning

confidence: 99%

Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes: A systematic review and meta‐analysis

Chiriacò

Pateras

Virdis

et al. 2019

Diabetes Obesity Metabolism

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“…Since 2010, several studies have reported a significant relationship between SBP variability and nephropathy (Hata et al, 2013; Kilpatrick et al, 2010; Noshad et al, 2014; Okada, Fukui, et al, 2012; Okada et al, 2013; Takao et al, 2014). This is the first study that demonstrated significant graded relationships between SBP variability and diabetic retinopathy and neuropathy.…”

Section: Discussionmentioning

confidence: 99%

“…The first was a post-hoc analysis of the Diabetes Control and Complication Trial data for patients with type 1 diabetes (Kilpatrick et al, 2010). The second was a case series of about 600 patients with type 2 diabetes and without diabetic retinopathy at baseline (Takao et al, 2014). Neither of these studies found any relationship between the two.…”

Section: Discussionmentioning

confidence: 99%

“…In the past few years, studies have shown that blood pressure variability (BPV) is an independent predictor of coronary heart disease, stroke, cognitive dysfunction, and all-cause mortality (Epstein, Lane, Farlow, et al, 2013; Muntner, Whittle, Lynch, et al, 2015; Muntner et al, 2011; Rothwell, Howard, Dolan, et al, 2010a) and that BPV may directly cause end organ damage (Su, 2006). In diabetic patients, several studies (Kilpatrick, Rigby, & Atkin, 2010; Okada, Fukui, Tanaka, et al, 2012; Okada, Fukui, Tanaka, et al, 2013; Okada, Matsumoto, Nagaoka, & Nakao, 2012; Takao, Matsuyama, Yanagisawa, Kikuchi, & Kawazu, 2014) have consistently shown that excessive BPV is an independent predictor of nephropathy and its precursors such as micro- (Noshad, Mousavizadeh, Mozafari, Nakhjavani, & Esteghamati, 2014) and macroalbuminuria (Ushigome, Fukui, Hamaguchi, et al, 2011). However, the relationship between BPV and retinopathy or neuropathy is still uncertain.…”

Section: Introductionmentioning

confidence: 99%

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Visit-to-visit systolic blood pressure variability and microvascular complications among patients with diabetes

Sohn

Epstein

Huang

et al. 2017

Journal of Diabetes and its Complications

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Aims To examine the relationship between systolic blood pressure (SBP) variability and the risk of microvascular complications in a non-elderly diabetic population. Methods This is a retrospective cohort study of individuals aged ≤60 years treated for diabetes in 2003 in the US Department of Veterans Affairs healthcare system. Individuals were followed for five years for any new diagnosis of diabetic nephropathy, retinopathy, or neuropathy. In each year of follow-up, individuals were classified into quartiles based on their SBP variability. Results We identified 208,338 patients with diabetes without diabetic nephropathy, retinopathy, or neuropathy at baseline. Compared to individuals with the least SBP variability (Quartile 1), those with most variability (Quartile 4) had 81% (OR = 1.81; 95% CI, 1.72–1.91), 17% (OR = 1.17; 95% CI, 1.13–1.21), 30% (OR = 1.30; 95% CI, 1.25–1.35), and 19% (OR = 1.19; 95% CI, 1.15–1.23) higher incidence of nephropathy, retinopathy, neuropathy, and any complication, respectively, after adjusting for mean SBP, demographic and clinical factors. Conclusions We found a significant graded relationship between SBP variability and the incidence of each complication and of any combined endpoint. This is the first study showing a significant association between SBP variability and the risk of diabetic retinopathy and neuropathy.

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“…Overall, risk of total mortality [25], progression to end stage renal disease [28], and cardiovascular disease [25] associated with high VVV was observed. Similarly, high VVV was also associated to progression of albuminuria and worsening of renal function mainly in diabetic patients [15,[29][30][31], although a few studies reported no association [32].…”

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confidence: 99%

The risk of visit-to-visit blood pressure variability in chronic kidney disease

Redón

2016

Journal of Hypertension

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Visit-to-visit variability in systolic blood pressure predicts development and progression of diabetic nephropathy, but not retinopathy, in patients with type 2 diabetes

Cited by 29 publications

References 27 publications

Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes: A systematic review and meta‐analysis

Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes: A systematic review and meta‐analysis

Visit-to-visit systolic blood pressure variability and microvascular complications among patients with diabetes

The risk of visit-to-visit blood pressure variability in chronic kidney disease

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