Joint effect of blood pressure and glycemic variation on the risk of cardiovascular morbidity and mortality in persons with type 2 diabetes

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Title:	Joint effect of blood pressure and glycemic variation on the risk of cardiovascular morbidity and mortality in persons with type 2 diabetes
Authors:	林正介;Li, Chia-Ing;Li, Chia-Ing;Juan, Ya-Ling;Juan, Ya-Ling;Chiu-Shong, L;Liu, Chiu-Shong;Chih-Hsueh, L;Lin, Chih-Hsueh;Yan, Shing-Yu;Yang, Shing-Yu;李采娟;Li, Tsai-Chung
Contributors:	醫學暨健康學院健康產業管理學系
Keywords:	Blood pressure;Glycemic;Mortality;Type 2 diabetes.
Date:	2022-09-01
Issue Date:	2023-03-29 01:27:44 (UTC+0)
Publisher:	亞洲大學
Abstract:	Objective: Few studies have explored the association of visit-to-visit variation in blood pressure (BP) and glycemic factors with cardiovascular disease (CVD) morbidity and mortality. This study aimed to examine the independent and joint effect of visit-to-visit BP and glycemic variation on CVD morbidity and mortality in persons with T2DM. Methods: The present study consisted of two retrospective cohort studies. The Taiwan Diabetes Study was based on a database of the National Diabetes Care Management Program (DCMP) and linked with cardiovascular morbidity incidence. The Taichung Diabetes Study was based on the DCMP database of a medical center, which can be linked with the National Death Registry dataset. The outcomes were analyzed by using Cox's proportional hazard models. Results: A total of 13,280 and 10,894 persons with T2DM in Taiwan and Taichung Diabetes Study, respectively, were included. SBP-CV, FPG-CV, and HbA1c-CV were significant predictors of stroke, CVD event or death, all-cause mortality, and expanded CVD mortality, whereas DBP-CV was a significant predictor of all-cause mortality and expanded and non-expanded CVD mortality. The joint effect of SBP, FPG, and HbA1c predicted the incidence of stroke and CVD event or death with increased risks of 16 %-35 %. In addition, the joint effect of SBP, DBP, FPG, and HbA1c was associated with all-cause and expanded CVD mortality with increased risks of 29 %-81 %. Conclusions: The joint effect of BP and glucose variation improved the prediction of cardiovascular morbidity and mortality. Moreover, simultaneous measurement of visit-to-visit BP and glycemic variation may stratify persons with cardiovascular risks and may be regarded as important therapeutic goals in the care of T2DM.
Appears in Collections:	[Department of Healthcare Administration] Journal Article

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