Japan: Long-term variability in systolic blood pressure (SBP) is tied to an increased risk of type 2 diabetes mellitus (T2DM) irrespective of baseline sex, age, lifestyle factors, FBG, and SBP, according to findings from the Aichi Workers' Cohort Study published in Hypertension Research.
Previous studies have shown that short-term variability in blood pressure is linked with T2DM incidence but there is no clarity on the association with long-term blood pressure variability (BPV). Hiroshi Yatsuya, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan, and colleagues aimed to examine the associations of long-term BPV and the time trend of blood pressure changes over time with T2DM incidence.

For this purpose, the researchers followed a cohort of 3017 Japanese patients (2446 male, 571 female) aged 36–65 years from 2007 through March 31, 2019. The slope of systolic BP change and the root-mean-square error (RMSE) regressed on year were calculated individually using SBP values obtained from 2003 to baseline (2007).
To estimate hazard ratios (HRs), a multivariable Cox proportional hazard model was applied for tertiles of SBP RMSE and continuous SBP slopes after adjusting for age, sex, smoking status, regular exercise, sodium intake, family history of diabetes, sleep disorder, body mass index (BMI), SBP, and fasting blood glucose (FBG) at baseline, and BMI slope from 2003 to 2007.
The key findings of the study were as follows:
The highest RMSE tertile compared to the lowest was associated with a significantly higher incidence of T2DM after adjusting for covariates (HR: 1.79).
The slope was also significantly associated with T2DM incidence until baseline SBP and FBG were adjusted (HR: 1.03).
Based on the findings the researchers conclude, that "long-term SBP variability was significantly associated with an increased incidence of T2DM independent of baseline age, BMI, sex, FBG, SBP, lifestyle factors and BMI slope from 2003 until baseline.
Reference:
Song, Z., He, Y., Chiang, C. et al. Long-term variability and change trend of systolic blood pressure and risk of type 2 diabetes mellitus in middle-aged Japanese individuals: findings of the Aichi Workers' Cohort Study. Hypertens Res (2022). https://doi.org/10.1038/s41440-022-00993-2