Background: Relationship between blood pressure (BP) and blood glucose control is still unsure. This study aimed to find whether visit-to-visit variability (VVV) of BP could be an independent risk factor for blood glucose control.
Methods: A retrospective analysis was conducted in 95254 Chinese primary care diabetic patients from Oct. 2014 to Nov. 2018 with repeated measurements of BP and fasting plasma glucose (FPG) every 3 months, including 3 cohorts: Putuo District diabetes cohort (PTD, N=43590), Xuhui District diabetes cohort (XHD, N=45451) and Changning District diabetes cohort (CND, N=6213). The VVV of systolic blood pressure (SBP) was evaluated by average successive difference (ASD), and glucose control was evaluated by “FPG well-controlled proportion” (FPG≤7mmol/L as “well-controlled”), over 16 follow-ups. Logistic regression was used to explore the association of SBP ASD and FPG well-controlled proportion. The full model adjusted the baseline characteristics considering age, gender, BMI, exercise, medication and diet. Model was built in PTD and validated in the other 2 cohorts.
Results: Patients in PTD can be divided into 3 groups by VVV of SBP, which were “stable,” “fluctuating” and “highly fluctuating” groups. With “stable” group as reference, higher VVV of SBP was associated with lower FPG well-controlled proportion. In PTD, “fluctuating” group, OR: 1.18, 95% CI: 1.13-1.24; “highly fluctuating” group, OR: 1.42, 95% CI: 1.35-1.49. Results were consistent in the 2 validated cohorts and ORs for the “highly fluctuating” group were 2.37, 95% CI: 2.23-2.52 and 1.34, 95% CI: 1.15-1.56. In the whole population (N =95254), “highly fluctuating” group was associated with the worst blood glucose control with OR: 1.67, 95% CI: 1.62-1.73.
Conclusion: High VVV of SBP could be an independent risk factor for blood glucose control, which suggests extra surveillance for those with highly fluctuating SBP.
S. Zhang: None. L. Xie: None. W. Zhang: None. B. Qian: None.
