Association of Visit-to-Visit Variability of Blood Pressure with Cardiovascular Disease among Type 2 Diabetes Mellitus Patients: A Cohort Study

BACKGROUND: Increasing evidence has shown that visit-to-visit variability (VVV) of blood pressure (BP) is associated with an increased risk of cardiovascular disease (CVD). The objective of this study was to evaluate the impact of VVV of systolic blood pressure (SBP) and diastolic blood pressure (DBP) on the risk of CVD among patients with type 2 diabetes mellitus (T2DM) in China. METHODS: We conducted a retrospective cohort study of 10,163 T2DM patients who were not previously diagnosed with CVD from January 2008 to December 2012 in Ningbo, China. The VVV of BP was calculated using five metrics, including standard deviation (SD), coefficient of variation (CV), variation independent of mean, average real variability, and successive variability (SV) of measurements, obtained over a 24-month measurement period. Hazard ratios and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression models for the associations of variability in BP with risk of CVD. RESULTS: A total of 894 CVD events were observed during a median follow-up of 49.5 months. The hazard ratio in the highest quintile of SD of SBP was 1.24 (95% CI, 1.01 to 1.52) compared with patients in the lowest quintile. The association between higher VVV of DBP and risk of CVD was not consistent across different metrics and sensitivity analyses. CONCLUSION: Higher VVV of SBP was associated with an increased risk of CVD, irrespective of the mean SBP level. Future studies are needed to confirm these findings.

A study on subjective well-being status and influencing factors among old people in Hangzhou City / 预防医学

Objective To analyze the subjective well-being of the aged and to explore its influencing factors in Hangzhou City to provide evidence for improving the subjective well-being of the aged. Method A total of 60 years old and above healthy people in Hangzhou were selected as research objects. Stratified random sampling was used according to age and gender. Face to face interview was conducted using a structured questionnaire. The content of the interview included subjective well-being,behavioral habits,and demographics. Statistical methods contains Wilcoxon signed-rank test, Kruskal-Wallis H test and Spearman rank correlation. Logistic regression was used to select influencing factors of subjective well-being. Results A total of 429 samples were used in the analysis according to inclusion and exclusion criterion. The mean score of subjective well-being was 14.0±2.0,and the result of logistic regression shows that gender,marriage status,the number of people living together,whether experienced negative life events,the number of people that can provide information were important factors of subjective well-being. Conclusions The level of subjective well-being of elderly people in Hangzhou was high. The government and society should improve SWB among the aged by providing more psychological guidance and more social support.