Highlights
- •The effects of BP and glycemic variation were associated with CVD events or death.
- •The joint effects of BP and glycemic variation predicted CVD events or death.
- •Simultaneous measuring BP and glycemic variation may be more precise to stratify persons with cardiovascular risks.
Abstract
Objective
Few studies have explored the association of visit-to-visit variation in blood pressure
(BP) and glycemic factors with cardiovascular disease (CVD) morbidity and mortality.
This study aimed to examine the independent and joint effect of visit-to-visit BP
and glycemic variation on CVD morbidity and mortality in persons with T2DM.
Methods
The present study consisted of two retrospective cohort studies. The Taiwan Diabetes
Study was based on a database of the National Diabetes Care Management Program (DCMP)
and linked with cardiovascular morbidity incidence. The Taichung Diabetes Study was
based on the DCMP database of a medical center, which can be linked with the National
Death Registry dataset. The outcomes were analyzed by using Cox's proportional hazard
models.
Results
A total of 13,280 and 10,894 persons with T2DM in Taiwan and Taichung Diabetes Study,
respectively, were included. SBP-CV, FPG-CV, and HbA1c-CV were significant predictors
of stroke, CVD event or death, all-cause mortality, and expanded CVD mortality, whereas
DBP-CV was a significant predictor of all-cause mortality and expanded and non-expanded
CVD mortality. The joint effect of SBP, FPG, and HbA1c predicted the incidence of
stroke and CVD event or death with increased risks of 16 %–35 %. In addition, the
joint effect of SBP, DBP, FPG, and HbA1c was associated with all-cause and expanded
CVD mortality with increased risks of 29 %–81 %.
Conclusions
The joint effect of BP and glucose variation improved the prediction of cardiovascular
morbidity and mortality. Moreover, simultaneous measurement of visit-to-visit BP and
glycemic variation may stratify persons with cardiovascular risks and may be regarded
as important therapeutic goals in the care of T2DM.
Keywords
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Article info
Publication history
Published online: September 01, 2022
Accepted:
August 29,
2022
Received:
June 8,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
