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J Diabetes Complications. 2017 Jan;31(1):195-201. doi: 10.1016/j.jdiacomp.2016.09.003. Epub 2016 Sep 14.

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

Author information

1
Department of Public Health Sciences, School of Medicine, University of Virginia, PO Box 800717, Charlottesville, VA 22908. Electronic address: msohn@virginia.edu.
2
Medical and Research Services, Hines VA Hospital, 5000 South 5th Avenue, Hines, IL 60141.
3
Department of Medicine, the University of Chicago, 924 East 57th Street, Chicago, IL 60637.
4
Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, 5000 South 5th Avenue, Hines, IL 60141.
5
Medical and Research Services, Hines VA Hospital, 5000 South 5th Avenue, Hines, IL 60141; Stritch School of Medicine, Loyola University Chicago, 2160 S 1st Avenue, Maywood, IL 60153.
6
Department of Public Health Sciences, School of Medicine, University of Virginia, PO Box 800717, Charlottesville, VA 22908.
7
Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, 5000 South 5th Avenue, Hines, IL 60141; Department of Physical Medicine and Rehabilitation, Northwestern University, 710 North Lake Shore Drive #1022, Chicago, IL 60611.
8
Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, 5000 South 5th Avenue, Hines, IL 60141; Stritch School of Medicine, Loyola University Chicago, 2160 S 1st Avenue, Maywood, IL 60153.

Abstract

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 ≤60years 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.

KEYWORDS:

Blood pressure variability; Microvascular complications; Nephropathy; Neuropathy; Retinopathy

PMID:
27671535
PMCID:
PMC5209256
DOI:
10.1016/j.jdiacomp.2016.09.003
[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

There is no conflict of interest to declare.

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