Long-Term Visit-To-Visit Blood Pressure Variability and Risk of Diabetes Mellitus in Chinese Population: A Retrospective Population-Based Study

Rui Zhou; Fu-Rong Li; Kuan Liu; Rui-Dian Huang; Hua-Min Liu; Ze-Lin Yuan; Jia-Zhen Zheng; Meng-Chen Zou; Xian-Bo Wu

doi:10.3389/ijph.2023.1605445

Long-Term Visit-To-Visit Blood Pressure Variability and Risk of Diabetes Mellitus in Chinese Population: A Retrospective Population-Based Study

Int J Public Health. 2023 Feb 6:68:1605445. doi: 10.3389/ijph.2023.1605445. eCollection 2023.

Authors

Rui Zhou¹, Fu-Rong Li^{1

2}, Kuan Liu¹, Rui-Dian Huang³, Hua-Min Liu⁴, Ze-Lin Yuan¹, Jia-Zhen Zheng^{5

6}, Meng-Chen Zou⁷, Xian-Bo Wu¹

Affiliations

¹ Guangdong Provincial Key Laboratory of Tropical Disease Research, Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China.
² School of Medicine, Southern University of Science and Technology, Shenzhen, China.
³ Public Health Division, Hospital of Zhongluotan, Guangzhou, China.
⁴ Department of Anaesthesiology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
⁵ Bioscience and Biomedical Engineering Thrust, Systems Hub, The Hong Kong University of Science and Technology (Guangzhou), Guangzhou, China.
⁶ Bioscience and Biomedical Engineering Thrust, Systems Hub, The Hong Kong University of Science and Technology, Hong kong, Hong Kong SAR, China.
⁷ Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Abstract

Objectives: To examine the association between visit-to-visit blood pressure variability (BPV) and incident diabetes mellitus (DM) risk in a Chinese population. Methods: Data comes from China Health and Nutrition Survey (n = 15,084). BPV was estimated as the average real variability (ARV) using at least three BP measurements from the year preceding the event and was divided into quartiles. Participants were also categorized into 9 groups on the basis of combinations of systolic BPV (SBPV) and diastolic BPV (DBPV) tertiles. Cox proportional hazards regression models were used. Results: During a median follow-up of 16.8 years, 1,030 (6.8%) participants developed diabetes (incidence rate: 4.65/1,000 person-years). The HRs (95% CIs) for the highest quartile (vs. the lowest quartile) of SBPV and DBPV were 1.60 (1.30-1.97) and 1.37 (1.13-1.67), respectively. Participants with both highest SBPV and DBPV tertile had an ≈89% higher risk of DM (HR, 1.89; 95% CI, 1.47-2.42) compared with those in the both SBPV and DBPV tertile 1 group. Conclusion: Higher SBP ARV and DBP ARV were independently associated with increased risk of incident DM, which was augmented when both presented together.

Keywords: China; blood pressure; cohort; diabetes mellitus; variability.

MeSH terms

Blood Pressure / physiology
China
Diabetes Mellitus*
East Asian People
Humans
Hypertension* / complications
Retrospective Studies
Risk Factors

Grants and funding

This work was supported by the National Natural Science Foundation of China (82173607), Guangdong Basic and Applied Basic Research Foundation (2021A1515011684), Open Project of the Guangdong Provincial Key Laboratory of Tropical Disease Research (2020B1212060042), and Guangzhou Science and Technology Project (202102080597). The sponsors played no role in the study design or implementation; data collection, management, analysis, and interpretation; manuscript preparation, review, or approval; or the decision to submit the manuscript for publication.