IMPACT OF HYPERGLYCAEMIA AND SEX ON DAY-TO-DAY HOME BLOOD PRESSURE VARIABILITY

Objective: Increased home blood pressure variability (HBPV) is a prognostic marker for cardiovascular events. The impact of hyperglycaemia and sex on HBPV in the general population have not been studied in detail. The objective of this study was to investigate the associations between glycaemic status and sex on four different HBPV markers. Design and method: In this cross-sectional study, we analysed HBPV in 4390 middle-aged participants from the Swedish CardioPulmonary bioImage Study (SCAPIS), who had recorded their home blood pressure in the morning and evening on seven consecutive days using a validated automatic home blood pressure device (Omron M10-IT). We calculated the Standard Deviation (SD), Coefficient of Variation (CV), Average Real Variability (ARV) and Variation Independent of the Mean (VIM). The differences in these HBPV indices between participants with normoglycaemia, prediabetes, newly diagnosed diabetes and previously known diabetes were assessed for statistical significance using one-way ANOVA. Differences between men and women were tested for statistical significance using Students Independent t test. Results: For three out of four systolic HBPV indices (SD, ARV and VIM), we found that normoglycaemic individuals (n=3477) had a statistically significant different degree of HBPV compared to individuals with prediabetes (n=604), new diabetes (n=112) and known diabetes (n=197): SD 7.4±2.6, 7.9±2.9, 8.0±2.5, 8.4±3.4, p <0.001; ARV 8.7±3.8, 9.3±4.2, 9.1±3.2, 9.7±4.8, p <0.001; and VIM 7.4±2.6, 7.8±2.8, 7.9±2.5, 8.2±3.3, p <0.001. Similar results were seen for diastolic HBPV (Table 1). Statistically significant differences were also seen between women and men, where women presented with a consistently higher systolic HBPV than men: SD 7.8±2.8 vs. 7.3±2.7, p<0.001; CV 6.7±2.3 vs. 5.8±2.0, p<0.001; ARV 9.2±3.9 vs. 8.5±3.9, p=<0.001; and VIM 7.8±2.7 vs. 7.2±2.6, p<0.001, and with higher diastolic CV (Table 1). Conclusions: Female sex, and dysglycaemia, were associated with higher home blood pressure variability. These results could be helpful for clinicians in assessing the cardiovascular risk of individuals.