ArticleJournal of hypertension2018
Increasing SBP variability is associated with an increased risk of developing incident diabetic foot ulcers.
Article in Journal of hypertension, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Risk Factors for First-Ever Diabetes-Related Foot Ulcer: A Systematic Review and Meta-Analysis.International wound journal · 2025Pooled it
- Correlations Among Visit-to-Visit Blood Pressure Variability and Treatment With Antihypertensive Medication With Long-Term Adverse Outcomes in a Large Veteran Cohort.American journal of hypertension · 2021Article
- Impact of in-hospital blood pressure variability on clinical outcomes in patients with symptomatic peripheral arterial disease.Hypertension research : official journal of the Japanese Society of Hypertension · 2021Article
- Preoperative outpatient blood pressure variability predicts postoperative mortality, readmission and morbidity after surgery.American journal of surgery · 2020Article
- Retrospective cohort study of the relationship between systolic blood pressure variability and multiple sclerosis disability.BMJ open · 2020Article
- Guidelines on multidisciplinary approaches for the prevention and management of diabetic foot disease (2020 edition).Burns & trauma · 2020Article
- Reply.Journal of hypertension · 2019Article
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Authors and funding
9 authors at 1 institution in 2 countries.
Funding
Abstract
objectiveSBP variability may be a target for mitigating end-organ damage associated with vascular disease. We evaluated the relationship between increased SBP variability and risk of incident diabetic foot ulceration.
methodsUsing a nested case-control design, we followed patients diagnosed with diabetes and treated within the US Department of Veterans Affairs Healthcare system for development of a diabetic foot ulcer (event) between 2006 and 2010. Each case was randomly matched to up to five controls based on age, sex, race/ethnicity, and calendar time. SBP variability was computed using at least three blood pressure measurements from the year preceding the event. The association between SBP variability and foot ulceration was examined using conditional logistic regression. Potential protective effects of calcium channel blockers, which blunt SBP variability, were also explored.
resultsThe study sample included 51 111 cases and 129 247 controls. Compared with those in quartile 1 (lowest variability), patients in quartiles 2-4 had higher adjusted odds ratios for diabetic foot ulcer development: 1.11 (95% CI 1.07-1.16), 1.20 (95% CI 1.15-1.25), 1.29 (95% CI 1.24-1.34) (P for trend <0.001). Calcium channel blockers were associated with reduced risks of ulceration for those without peripheral vascular disease (OR = 0.87, 95% CI 0.84-0.90, P < 0.001) or neuropathy (OR = 0.85, 95% CI 0.82-0.89, P < 0.001) in adjusted subgroup analyses.
conclusionThis study describes a graded relationship between SBP variability and risk of diabetic foot ulceration, providing a potential new and modifiable target to reduce this common complication.
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