{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T05:28:38Z","timestamp":1778909318495,"version":"3.51.4"},"reference-count":45,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2021,9,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The detrimental effects of increased variability in systolic blood pressure (SBP) on cardiovascular disease (CVD) and mortality risk in patients with diabetes mellitus remains unclear. This study evaluated age\u2010specific association of usual SBP visit\u2010to\u2010visit variability with CVD and mortality in patients with type 2 diabetes mellitus.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">A retrospective cohort study investigated 155\u00a0982 patients with diabetes mellitus aged 45 to 84\u00a0years without CVD at baseline (2008\u20132010). Usual SBP variability was estimated using SBP SD obtained from a mixed\u2010effects model. Age\u2010specific associations (45\u201354, 55\u201364, 65\u201374, 75\u201384\u00a0years) between usual SBP variability, CVD, and mortality risk were assessed by Cox regression adjusted for patient characteristics. After a median follow\u2010up of 9.7\u00a0years, 49\u00a0816 events (including 34\u00a0039 CVD events and 29\u00a0211 mortalities) were identified. Elevated SBP variability was independently, positively, and log\u2010linearly associated with higher CVD and mortality risk among all age groups, with no evidence of any threshold effects. The excess CVD and mortality risk per 5\u00a0mm\u00a0Hg increase in SBP variability within the 45 to 54 age group is &gt;3 times higher than the 70 to 79 age group (hazard ratio, 1.66; 95% CI, 1.49\u20131.85 versus hazard ratio, 1.19; 95% CI, 1.15\u20131.23). The significant associations remained consistent among all subgroups. Patients with younger age had a higher association of SBP variability with event outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The findings suggest that SBP visit\u2010to\u2010visit variability was strongly associated with CVD and mortality with no evidence of a threshold effect in a population with diabetes mellitus. As well as controlling overall blood pressure levels, SBP visit\u2010to\u2010visit variability should be monitored and evaluated in routine practice, in particular for younger patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.120.019026","type":"journal-article","created":{"date-parts":[[2021,8,16]],"date-time":"2021-08-16T17:46:00Z","timestamp":1629135960000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Age\u2010Specific Associations of Usual Blood Pressure Variability With Cardiovascular Disease and Mortality: 10\u2010Year Diabetes Mellitus Cohort Study"],"prefix":"10.1161","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6275-1147","authenticated-orcid":false,"given":"Eric Yuk Fai","family":"Wan","sequence":"first","affiliation":[{"name":"Department of Family Medicine and Primary Care The University of Hong Kong Hong Kong SAR China"},{"name":"Centre for Safe Medication Practice and Research Department of Pharmacology and Pharmacy The University of Hong Kong Hong Kong SAR China"},{"name":"Laboratory of Data Discovery for Health (D24H) Hong Kong Science and Technology Park Sha Tin Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7472-7083","authenticated-orcid":false,"given":"Esther Yee Tak","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care The University of Hong Kong Hong Kong SAR China"},{"name":"Department of Family Medicine and Primary Care The University of Hong Kong Shenzhen Hospital Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weng Yee","family":"Chin","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica K.","family":"Barrett","sequence":"additional","affiliation":[{"name":"Medical Research Council (MRC) Biostatistics Unit University of Cambridge Cambridge United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8242-0014","authenticated-orcid":false,"given":"Ian Chi Kei","family":"Wong","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research Department of Pharmacology and Pharmacy The University of Hong Kong Hong Kong SAR China"},{"name":"Laboratory of Data Discovery for Health (D24H) Hong Kong Science and Technology Park Sha Tin Hong Kong, China"},{"name":"Research Department of Practice and Policy School of Pharmacy University College London London United Kingdom"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7602-9470","authenticated-orcid":false,"given":"Esther Wai Yin","family":"Chan","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research Department of Pharmacology and Pharmacy The University of Hong Kong Hong Kong SAR China"},{"name":"Laboratory of Data Discovery for Health (D24H) Hong Kong Science and Technology Park Sha Tin Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celine Sze Ling","family":"Chui","sequence":"additional","affiliation":[{"name":"Centre for Safe Medication Practice and Research Department of Pharmacology and Pharmacy The University of Hong Kong Hong Kong SAR China"},{"name":"Laboratory of Data Discovery for Health (D24H) Hong Kong Science and Technology Park Sha Tin Hong Kong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shiqi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy Lo Kuen","family":"Lam","sequence":"additional","affiliation":[{"name":"Department of Family Medicine and Primary Care The University of Hong Kong Hong Kong SAR China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","volume-title":"IDF Diabetes Atlas Eighth Edition 2017","author":"International Diabetes Federation","year":"2017","unstructured":"International Diabetes Federation . 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