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

By 10 Ιουλίου 2019 11 Ιουλίου, 2019 Δημοσιεύσεις

Δημοσίευση στις 2019/7/10 στο PubMed:


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



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.


PubMed, Medline, Embase, Cinahl, Web of Science, 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.


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.


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.