Diabetes Care: Blood Pressure Variability and Heart Failure Risk

Although blood pressure variability is increasingly used as a risk factor for cardiovascular disease, the relationship with heart failure (HF) is not clearIn a recent study published in Diabetes Care, a leading journal of diabetes, researchers aimed to assess the relationship between blood pressure variability and HF risk in two type 2 diabetes queuesdata from the Diabetes Control Cardiovascular Risk Action Trial (ACCORD) and the Veterans Affairs Diabetes Trial (VADT)In both trials, the researchers calculated the coefficients of variation (CV) and the average actual variability (ARV) of systolic pressure (SBP) and diastolic pressure (DBP), as well as the maximum and cumulative average SBP and DBPin ACCORD, CV and ARV of SBP and DBP were also associated with increased HF risk (e.g., CV-SBP: 1.15, P-0.01; CV-DBP:HR 1.18, P-0.003) even after adjusting other risk factors and average blood pressureIn VADT, DBP variability is associated with increased HF risk (ARV-DBP: HR is 1.16, P is 0.001; CV-DBP:HR is 1.09, P-0.04)In addition, in ACCORD, patients with gradually reduced baseline blood pressure showed a gradual increase in the increased HF risk of CV-SBP, ARV-SBP, and CV-DBPBlood pressure variability is associated with a decrease in blood pressure, not an increaseit is shown that blood pressure variability is associated with HF risk in patients with type 2 diabetes, which may be the result of ischemia during diastolic periodThese results may be clinically significant in optimizing blood pressure treatment strategies in patients with type 2 diabetes