Abstract
Objectives: Increased day-by-day blood pressure (BP) variability assessed by home BP measurement has been associated with cardiovascular events in general and clinical population. However, few studies have examined these associations in patients with diabetes. The aim of this study is to investigate the association of day-by-day home BP variability of cardiovascular events in patients with diabetes enrolled in Japan Morning Surge-Home Blood Pressure (J-HOP) Study. Methods: Of 4,310 participant enrolled in J-HOP study, 1015 had diabetes. They underwent home BP monitoring in the morning and evening over a 14-day period, and their BP levels and BP variability independent of the mean (VIM) were assessed. Incident cardiovascular (CV) events included cardiovascular morbidity and mortality. Results: Mean (SD) home systolic BP (SBP) levels over time and VIMSBP were 136.2 (14.7) mmHg and 6.7 (2.3) unit, respectively. During a 4-year follow-up period, 69 CV events occurred. Mean home SBP per 1SD was not associated with CV events (Hazard ratio, 1.22; 95% CI, 0.95, 1.58), whereas VIMSBP per 1SD was associated with CV events independently of cardiovascular risk included mean home SBP (HR, 1.44; 95% CI, 1.15, 1.79, P = 0.001). Conclusion: In Japanese population with diabetes, day-by-day BP variability was independently associated with cardiovascular events.
Published Version
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