The Journal of clinical endocrinology and metabolism · 2022
Blood Pressure Variability and the Risk of Fracture: A Nationwide Cohort Study.
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Yoo Jung Eun, Yoon Ji Won, Park Hyo Eun, Han Kyungdo, Shin Dong Wook
Аннотация
CONTEXT: Although blood pressure variability (BPV) is associated with various health outcomes, only 1 study suggested that BPV is correlated with hip fractures. As cardiovascular disease and fractures share similar pathophysiology, there might be a link between BPV and fractures.
OBJECTIVE: To investigate the association between BPV and the incident fractures.
DESIGN: Retrospective cohort study.
SETTING: Population-based, using the Korean National Health Insurance System database.
PATIENTS OR OTHER PARTICIPANTS: A total of 3 256 070 participants aged ≥50 who participated in ≥3 health examinations within the previous 5 years, including the index year (2009-2010), were included. Outcome data were obtained through the end of 2016.
EXPOSURE: BPV was calculated using variability independent of the mean. High variability was defined as the highest quartile of variability.
MAIN OUTCOME MEASURES: Newly diagnosed fractures.
RESULTS: During the median follow-up of 7.0 years, there were 337 045 cases of any fracture (10.4%). After adjusting for age, sex, income, lifestyle factors, and comorbidities, a higher risk of fracture was observed with higher quartiles of BPV than the lowest quartile group: the adjusted hazard ratios (95% CIs) for incident any fracture were 1.07 (1.06-1.08) in the higher quartile of systolic BPV, 1.06 (1.05-1.07) in that of diastolic BPV, and 1.07 (1.06-1.08) in that of both systolic and diastolic BPV. Consistent results were noted for vertebral fractures and hip fractures, as well as in various subgroup analyses.
CONCLUSIONS: A positive association was noted between higher BPV and fracture incidence. BPV is an independent predictor for developing fracture.
OBJECTIVE: To investigate the association between BPV and the incident fractures.
DESIGN: Retrospective cohort study.
SETTING: Population-based, using the Korean National Health Insurance System database.
PATIENTS OR OTHER PARTICIPANTS: A total of 3 256 070 participants aged ≥50 who participated in ≥3 health examinations within the previous 5 years, including the index year (2009-2010), were included. Outcome data were obtained through the end of 2016.
EXPOSURE: BPV was calculated using variability independent of the mean. High variability was defined as the highest quartile of variability.
MAIN OUTCOME MEASURES: Newly diagnosed fractures.
RESULTS: During the median follow-up of 7.0 years, there were 337 045 cases of any fracture (10.4%). After adjusting for age, sex, income, lifestyle factors, and comorbidities, a higher risk of fracture was observed with higher quartiles of BPV than the lowest quartile group: the adjusted hazard ratios (95% CIs) for incident any fracture were 1.07 (1.06-1.08) in the higher quartile of systolic BPV, 1.06 (1.05-1.07) in that of diastolic BPV, and 1.07 (1.06-1.08) in that of both systolic and diastolic BPV. Consistent results were noted for vertebral fractures and hip fractures, as well as in various subgroup analyses.
CONCLUSIONS: A positive association was noted between higher BPV and fracture incidence. BPV is an independent predictor for developing fracture.