Τίτλος:
Association between blood pressure variability, cardiovascular disease and mortality in type 2 diabetes: A systematic review and meta-analysis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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
Συγγραφείς:
Chiriacò, M.
Pateras, K.
Virdis, A.
Charakida, M.
Kyriakopoulou, D.
Nannipieri, M.
Emdin, M.
Tsioufis, K.
Taddei, S.
Masi, S.
Georgiopoulos, G.
Περιοδικό:
Diabetes, Obesity and Metabolism
Εκδότης:
Wiley-Blackwell Publishing Ltd
Λέξεις-κλειδιά:
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
