Visit-to-visit variability in systolic blood pressure is correlated with diabetic nephropathy and atherosclerosis in patients with type 2 diabetes

ObjectiveRecent studies make remarks on the effect of variability in systolic blood pressure (SBP) on the development of cardiovascular disease. The aim of this study was to investigate the relationship between the variability in SBP and the degree of diabetic nephropathy and atherosclerosis in patients with type 2 diabetes.MethodsWe measured SBP in 422 consecutive patients with type 2 diabetes at every visit during a year, and we calculated the coefficient of variation (CV) of SBP. Then, we evaluated relationships of variability of SBP to degree of urinary albumin excretion (UAE), which is a useful marker for cardiovascular disease as well as diabetic nephropathy, ankle-brachial index (ABI) and pulse wave velocity (PWV).ResultsCV of SBP positively correlated with log UAE (r = 0.210, P < 0.0001) or PWV (r = 0.409, P < 0.0001), whereas CV of SBP inversely correlated with ABI (r = −0.098, P = 0.0463). Multiple regression analysis demonstrated that CV of SBP independently correlated with log UAE (β = 0.149, P = 0.0072), PWV (β = 0.337, P < 0.0001) or ABI (β = −0.162, P = 0.0101).ConclusionsNot only average SBP but also variability in SBP is correlated with diabetic nephropathy and atherosclerosis in patients with type 2 diabetes.