TY - JOUR
TI - Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes: A systematic review and meta-analysis
AU - Chiriacò, M.
AU - Pateras, K.
AU - Virdis, A.
AU - Charakida, M.
AU - Kyriakopoulou, D.
AU - Nannipieri, M.
AU - Emdin, M.
AU - Tsioufis, K.
AU - Taddei, S.
AU - Masi, S.
AU - Georgiopoulos, G.
JO - Diabetes, Obesity and Metabolism
PY - 2019
VL - 21
TODO - 12
SP - 2587-2598
PB - Wiley-Blackwell Publishing Ltd
SN - 1462-8902, 1463-1326
TODO - 10.1111/dom.13828
TODO - creatinine, all cause mortality;  arterial wall thickness;  Article;  blood pressure monitoring;  blood pressure variability;  cardiovascular disease;  cardiovascular risk;  clinical evaluation;  clinical outcome;  creatinine blood level;  diastolic blood pressure;  disease association;  glycemic control;  heart left ventricle hypertrophy;  human;  hypertension;  incidence;  long term care;  mean arterial pressure;  mortality risk;  non insulin dependent diabetes mellitus;  pulse wave;  qualitative analysis;  systematic review;  systolic blood pressure;  adult;  blood pressure;  cardiovascular disease;  complication;  female;  male;  meta analysis;  mortality;  non insulin dependent diabetes mellitus;  pathophysiology;  physiology, Adult;  Blood Pressure;  Cardiovascular Diseases;  Diabetes Mellitus, Type 2;  Female;  Humans;  Male
TODO - Aim: 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), extended MACEs, microvascular complications (MiCs) and hypertension-mediated organ damage (HMOD) in adult patients with type 2 diabetes. Materials and 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 variable 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 MiCs and/or HMOD. The extracted information was analyzed using random effects meta-analysis and meta-regression. Results: Data from a total of 377 305 patients were analyzed. 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 MiCs (HR 1. 12, 95% CI 1.01–1.24), while diastolic blood pressure 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 blood pressure, glycaemic control and serum creatinine levels. Conclusions: Our results suggest that BPV might provide additional information rather than mean blood pressure on the risk of cardiovascular disease in patients with type 2 diabetes. © 2019 John Wiley & Sons Ltd
ER -