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People with BMI, systolic BP, cholesterol and / or blood glucose fluctuate may be at higher risk of heart attack, stroke and all-cause mortality compared to those whose readings are more stable, according to a study published in circulation.
"Health care providers need to pay attention to the variability of the patient's blood pressure, cholesterol and glucose measurements, as well as weight," Seung-Hwan Lee, MD, PhD, Professor of Endocrinology at the College of Medicine of the Catholic University of Korea in Seoul, South Korea, said in a press release. "Trying to stabilize these measures can be an important step towards helping them improve their health."
To test the association between the variability of metabolic parameters (especially glucose and cholesterol concentrations, blood pressure and body mass index) and all-cause mortality rates, d & # 39; myocardial infarction and stroke, the researchers identified 6,748,773 participants in the Korean health insurance system with no history of myocardial infarction, diabetes, hypertension or hypercholesterolemia and having undergone at least three health examinations between 2005 and 2012.
The researchers used the coefficient of variation, the standard deviation and the variability independently of the mean and mean real variability to measure the variability of each of the four parameters.
Participants were ranked according to the number of metabolic parameters of high variability that they had using a score between 0 and 4.
MI, stroke or death recently diagnosed were the evaluation criteria of the study.
Participants were followed until the end of 2015 for a median of 5.5 years.
During the period of the study, 0.8% of the cohort died, 0.3% had a stroke and 0.3%, a myocardial infarction.
The researchers found that a high variability in each metabolic parameter was associated with a higher risk of all-cause mortality, myocardial infarction and stroke and that, in a multivariate model adjusted, the risk of results increased with the number of parameters of high variability (all causes). mortality: HR for 4 against 0 = 2.27; 95% CI, 2.13-2.42; MI: HR for 4 against 0 = 1.43; 95% CI, 1.25-1.64; Stroke: HR for 4 against 0 = 1.41; 95% CI, 1.25-1.60).
The results remained similar in various sensitivity analyzes and when modeling variability using standard deviation, variability independent of mean variability and average true variability, according to the researchers.
"It is not certain that these Korean results apply in the United States," Lee said in the statement. "However, several previous studies on variability have been done in other populations, suggesting that it would likely be a common phenomenon." – by Melissa J. Webb
Disclosures: The authors do not report any relevant financial information.
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