Association Between Blood Pressure Variability, Cardiovascular Disease And Mortality In Type 2 Diabetes: A Systematic Review And Meta-Analysis.

By 10 Ιουλίου 2019 Ιούλιος 11th, 2019 Δημοσιεύσεις

Δημοσίευση στις 2019/7/10 στο PubMed: https://www.ncbi.nlm.nih.gov/pubmed/31282073

 

Chiriacò M,, Pateras K, Virdis A, Charakida M, Kyriakopoulou D, Nannipieri M, Emdin M, Tsioufis C, Taddei S, Masi S,,, Georgiopoulos G,.

Abstract

OBJECTIVE:

This meta-analysis sought 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), extendend MACEs, microvascular complications (MiC) and hypertension-mediated organ damage (HMOD) in adult patients with type 2 diabetes.

METHODS:

PubMed, Medline, Embase, Cinahl, Web of Science, ClinicalTrials.gov and grey literature databases were searched for studies including patients with type 2 diabetes, at least one parameter 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 MiC and/or HMOD. The extracted information was analysed using random-effects meta-analysis and meta-regression.

RESULTS:

Data from a total of 377,305 patients were analysed. 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 MiC (HR 1. 12, 95% CI 1.01-1.24), while diastolic blood pressure (DBP) 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 BP, glycemic control and serum creatinine levels.

CONCLUSIONS:

Our results suggest that BPV might provide additional information than mean blood pressure on the risk of CVD in patients with type 2 diabetes. This article is protected by copyright. All rights reserved.

error: