Abstract
Summary
We investigated the association between blood pressure variability measured by the coefficient of variation (CV) of blood pressure and hip fracture in older persons with diabetes. After excluding patients with acute complications and comorbidities, a positive association with similar magnitude of strength was found between BP variability and hip fracture, compared with that in the original analysis.
Introduction
Hypertension is a risk factor of osteoporosis and hip fracture, but studies have yet to investigate whether blood pressure variability measured by the CV of blood pressure can predict hip fracture in older persons with diabetes.
Methods
We conducted a retrospective cohort study on 21,160 patients who suffered from type 2 diabetes (age ≥ 50 years) and participated in the National Diabetes Care Management Program in Taiwan. The patients’ 1-year variability in systolic blood pressure (SBP) and diastolic blood pressure (DBP) at the baseline and subsequent hip fracture incidence for 8.2 years were analyzed.
Results
There were 937 recorded incident hip fractures. SBP-CV and DBP-CV were classified based on their tertiles. After multivariate adjustment was conducted, SBP-CV found to be a predictor of hip fracture, and its hazard ratio was 1.18 (95% CI 1.00–1.40) for the third tertile compared with the first tertile.
Conclusions
Our study suggests SBP stability is a predictor for hip fracture incidence in older persons with type 2 diabetes.
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Abbreviations
- DM:
-
diabetes mellitus
- FPG:
-
fasting plasma glucose
- BP:
-
blood pressure
- NDCMP:
-
National Diabetes Care Management Program
- NHI:
-
National Health Insurance
- PIN:
-
personal identification number
- CAD:
-
coronary artery disease
- CVs:
-
coefficients of variability
- SBP:
-
systolic blood pressure
- DBP:
-
diastolic blood pressure
- HRs:
-
hazard ratios
- CIs:
-
confidence intervals
- OAD:
-
oral glucose-lowering drug
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Acknowledgements
This study was supported primarily by the Bureau of National Health Insurance (DOH94-NH-1007); the Ministry of Science and Technology of Taiwan (NSC 101-2314-B-039-017-MY3 & NSC 102-2314-B-039-005-MY2 & MOST 104-2314-B-039-016, MOST 105-2314-B-039-021-MY3 & MOST 105-2314-B-039-025-MY3); the Ministry of Health and Welfare, Taiwan (MOHW107-TDU-B-212-123004); and China Medical University Hospital (DMR-107-119).
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This study was approved by the Ethical Review Board of China Medical University Hospital (CMUH102-REC3-016).
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Li, TC., Li, CI., Liu, CS. et al. Visit-to-visit blood pressure variability and hip fracture risk in older persons. Osteoporos Int 30, 763–770 (2019). https://doi.org/10.1007/s00198-019-04899-7
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DOI: https://doi.org/10.1007/s00198-019-04899-7