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Blood pressure variability in individuals with and without (pre)diabetes: the Maastricht Study

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Abstract

Objective: The mechanisms associating (pre)diabetes and cardiovascular disease (CVD) are incompletely understood. We hypothesize that greater blood pressure variability (BPV) may underlie this association, due to its association
with (incident) CVD. Therefore, we investigated the association between (pre)diabetes and very short-term to mid-term BPV, that is within-visit, 24-h and 7-day BPV.

Methods: Cross-sectional data from The Maastricht Study [normal glucose metabolism (NGM), n¼1924; prediabetes, n¼511; type 2 diabetes mellitus (T2DM), n¼975; 51%
men, aged 608 years]. We determined SD for within visit BPV (n¼3244), average real variability for 24-h BPV (n¼2699) day (0900–2100 h) and night (0100–0600 h) separately, and SD for 7-day BPV (n¼2259). Differences in
BPV as compared with NGM were assessed by multiple linear regressions with adjustment for potential confounders.

Results: In T2DM, the average systolic/diastolic values of within-visit, 24-h and 7-day BPV were 4.8/2.6, 10.5/7.3 and 10.4/6.5 mmHg, respectively, and in prediabetes 4.9/ 2.6, 10.3/7.0 and 9.4/5.9 mmHg, respectively. T2DM was associated with greater nocturnal systolic BPV [0.42mmHg (95% confidence interval: 0.05–0.80)], and greater 7-day
systolic [0.76mmHg (0.32–1.19)] and diastolic BPV [0.65mmHg (0.29–1.01)], whereas prediabetes was associated with greater within-visit systolic BPV only [0.35mmHg (0.06–0.65)], as compared with NGM.

Conclusion: Both T2DM and prediabetes are associated with slightly greater very short-term to mid-term BPV, which may, according to previous literature, explain a small part of the increased CVD risk seen in (pre)diabetes.
Nevertheless, these findings do not detract from the fact that very short-term to mid-term BPV is substantial and important in individuals with and without (pre)diabetes.

    Research areas

  • average real variability, blood pressure variability, cardiovascular diseases, diabetes mellitus, prediabetic state, TO-VISIT VARIABILITY, AMERICAN-HEART-ASSOCIATION, OBSTRUCTIVE SLEEP-APNEA, DIABETES-MELLITUS, PROGNOSTIC-SIGNIFICANCE, BAROREFLEX SENSITIVITY, ARTERIAL STIFFNESS, EUROPEAN-SOCIETY, ALL-CAUSE, HYPERTENSION
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Details

Original languageEnglish
Pages (from-to)259-267
Number of pages9
JournalJournal of Hypertension
Volume36
Issue number2
DOIs
Publication statusPublished - Feb 2018