Background: Visit-to-visit variability in single biological measurements has been associated with cognitive decline and an elevated risk of cardiovascular diseases (CVD). However, the effect of visit-to-visit variability in multiple biological measures is underexplored. We investigated the effect of visit-to-visit variability in blood pressure (BP), heart rate (HR), weight, fasting plasma glucose, cholesterol, and triglycerides on cognitive performance and CVD.
Methods: Data on BP, HR, weight, glucose, cholesterol, and triglycerides from study visits in the Outcome Reduction with Initial Glargine Intervention (ORIGIN) trial were used to estimate the association between visit-to-visit variability, cognitive performance (Mini Mental State Examination (MMSE) score) and CVD (non-fatal stroke, non-fatal myocardial infarction, or cardiovascular death). Visit-to-visit variation for each measurement was estimated by calculating each individuals visit-to-visit standard deviation for that measurement. Participants whose standard deviation was in the highest quarter were classified as having high variation. Participants were grouped into those having 0, 1, 2, 3, or ≥ 4 high variation measurements. Regression and survival models were used to estimate the association between biological measures with MMSE and CVD with adjustment for confounders and mean measurement value.
Results: After adjustment for covariates, higher visit-to-visit variability in BP, HR, weight, and FPG were associated with poorer MMSE and a higher risk of CVD. Effect sizes did not vary greatly by measurement. The effects of high visit-to-visit variability were additive; compared to participants who had no measurements with high visit-to-visit variability, those who had high visit-to-visit variability in ≥4 measurements had poorer MMSE scores (-0.63 (95 % CI -0.96 to -0·31). Participants with ≥4 measurements with high visit-to-visit variability compared to participants with none had higher risk of CVD (hazard ratio 2.46 (95 % CI 1.63 to 3.70).
Conclusion: Visit-to-visit variability in several measurements were associated with cumulatively poorer cognitive performance and a greater risk of CVD.
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http://dx.doi.org/10.1016/j.cccb.2024.100223 | DOI Listing |
J Hypertens
December 2024
Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
Background: People with diabetes often have increased blood pressure (BP) variability because of autonomic dysfunction and arterial stiffness, making it a critical factor in predicting clinical outcomes. We investigated the reproducibility of long-term visit-to-visit BP variability (VVV) and the minimum number of BP readings to reliably determine VVV in people with diabetes.
Methods: This multicenter retrospective study used data from electronic health records of the Korea University Medical Center database.
J Alzheimers Dis
December 2024
Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
Background: Blood pressure (BP) variability (BPV) and time in target range (TTR) are emerging vascular risk factors for dementia, independent of traditionally targeted mean BP.
Objective: Determine whether BPV or TTR is most strongly associated with cognitive risk.
Methods: In this post hoc analysis of the SPRINT trial, 8034 participants underwent repeated BP measurement and cognitive testing at baseline and follow-up.
Neurology
January 2025
From the Rush Institute for Healthy Aging (A.D., K.D., P.D., D.A.E., K.B.R.), and Department of Internal Medicine (A.D., K.D., P.D., D.A.E., K.B.R.), Rush University Medical Center, Chicago, IL; and Department of Neurology (C.S.D., K.B.R.), University of California at Davis, Sacramento.
Heliyon
November 2024
Hongqiao International Institute of Medicine, Shanghai Tongren Hospital and Clinical Research Institute, Shanghai Jiao Tong University School of Medicine, China.
Visit-to-visit blood pressure variability is a factor for a series of cardiovascular diseases in hypertensive patients. Hypertension is a common complication of patients with type 2 diabetes mellitus. Our research demonstrated that blood pressure variability is more important than systolic blood pressure to be associated with the occurrence of coronary artery disease and stroke.
View Article and Find Full Text PDFJ Diabetes Complications
January 2025
Division of Endocrinology and Metabolism, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea. Electronic address:
Aims: This study aimed to investigate the correlations between glycated hemoglobin (HbA1C) variability and diabetes distress (DD) and its subscales in older patients with type 2 diabetes mellitus.
Methods: The cross-sectional study analyzed 175 patients with type 2 diabetes mellitus, aged ≥60 years, and underwent HbA1C testing at least three times within a 2-year. HbA1C variability was assessed using the coefficient of variation (CV), standard deviation (SD), variability independent of the mean (VIM), and variability score.
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