Evidence map›Paper›PMID 26629346›Full record

ArticleBMJ open diabetes research & care2015

The combined effect of visit-to-visit variability in HbA1c and systolic blood pressure on the incidence of cardiovascular events in patients with type 2 diabetes.

Toshiko Takao, Yutaka Matsuyama, Machi Suka, Hiroyuki Yanagisawa, Yasuhiko Iwamoto

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Article in BMJ open diabetes research & care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  14. Clinical features and therapeutic perspectives on hypertension in diabetics.Hypertension research : official journal of the Japanese Society of Hypertension · 2018
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  16. Article
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  19. Amelioration of arterial pressure lability: an unmissable target for diabetes management.Hypertension research : official journal of the Japanese Society of Hypertension · 2017
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Toshiko TakaoDivision of Diabetes and Metabolism , The Institute for Adult Diseases, Asahi Life Foundation , Tokyo , Japan.
Yutaka MatsuyamaDepartment of Biostatistics , School of Public Health, University of Tokyo , Tokyo , Japan.
Machi SukaDepartment of Public Health and Environmental Medicine , The Jikei University School of Medicine , Tokyo , Japan.
Hiroyuki YanagisawaDepartment of Public Health and Environmental Medicine , The Jikei University School of Medicine , Tokyo , Japan.
Yasuhiko IwamotoDivision of Diabetes and Metabolism , The Institute for Adult Diseases, Asahi Life Foundation , Tokyo , Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the association between long-term visit-to-visit variability in glycated hemoglobin (HbA1c) and systolic blood pressure (SBP) and the incidence of cardiovascular disease (CVD) in patients with type 2 diabetes.

methodsWe retrospectively enrolled 632 patients with type 2 diabetes and no history of CVD who first visited our hospital between 1995 and 1996, were followed-up for ≥1 year, attended at least 4 clinic visits and had at least 1 visit per year. Patients were followed until June 2012 at the latest, and mailed questionnaires.

resultsDuring the median follow-up period (15.4 years), 81 patients developed CVD. Multivariate analysis revealed that the coefficient of variation (CV) and the variation independent of mean (VIM) for HbA1c and SBP were significant predictors of CVD incidence independent of mean HbA1c and SBP. Patients were classified into 4 groups by median HbA1cCV and SBPCV values and by median HbA1cVIM and SBPVIM values. Among these groups, the HRs were highest in the high-HbA1cCV/high-SBPCV and high-HbA1cVIM/high-SBPVIM groups and were significantly higher compared with those in the low-HbA1cCV/low-SBPCV and low-HbA1cVIM/low-SBPVIM groups, respectively. Among patients with mean SBP≥130 mm Hg, the HRs associated with HbA1cCV and HbA1cVIM were drastically elevated compared with those with mean SBP<130 mm Hg (interaction p<0.05).

conclusionsLong-term visit-to-visit variability in HbA1c and SBP represented a combined and additive risk for CVD incidence in patients with type 2 diabetes. It is suggested that a synergistic effect exists between HbA1c variability and mean SBP levels for CVD incidence.

Indexed as

Blood PressureCardiovacsular Disease(s)HbA1cType 2 Diabetes

Identifiers

PMID26629346
PMCPMC4653863

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.