Diabetes Care: Blood Pressure Variability and Risk of Heart Failure

Although more and more studies have shown that blood pressure variability is a risk factor for cardiovascular disease, the relationship with heart failure (HF) is unclearIn a recent study published in Diabetes Care, a leading journal of diabetes, researchers used two type 2 diabetes queues in blood glucose and/or other risk management trials to assess the relationship between blood pressure variability and HF riskdata from the Diabetes Control Cardiovascular Risk Initiative (ACCORD) trial 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 are 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, the individual HF risk of gradually decreasing baseline blood pressure increased with increased CV-SBP, ARV-SBP, and CV-DBPThe effect of blood pressure variability is related to a decrease in blood pressure, but not to an increase in blood pressureit 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 important in optimizing blood pressure treatment strategies in patients with type 2 diabetes