Five BP readings establish BP variability to predict cardiac risk in diabetics

Long-term visit-to-visit variability in blood pressure (BP) may be used to predict cardiovascular outcomes in people with diabetes, suggests a study. At least five BP measurements are necessary to effectively estimate intraindividual VVV and assess cardiovascular risk.

A total of 10,475 people with diabetes (mean age 65.2 years) were included, of whom 53.2 percent were men and 87.4 percent had comorbid hypertension.

Systolic (S)BP readings of five or more best predicted the incidence of MACE at 3 years. The mean coefficients of these readings were 8.4 for three readings, 9.5 for five, 9.0 for both seven and nine, and 9.7 for all readings.

Patients with high VVV (coefficient of variation of five SBP readings >9) had a higher incidence of 3-year MACE than those with low VVV (10.1 percent vs 5.4 percent; p<0.001). Multivariate analysis revealed that high VVV of both SBP and diastolic BP independently predicted 3-year MACE.

In this multicentre retrospective study, researchers used data from electronic health records of the Korea University Medical Center database. They identified individuals with diabetes who had more than nine BP readings during a maximum period of 2 years. The analysis centred on the coefficient of variation of these readings and their association with MACE over a follow-up period of 3 years.

“People with diabetes often have increased BP variability because of autonomic dysfunction and arterial stiffness, making it a critical factor in predicting clinical outcomes,” the researchers said.