THE IMPACT OF VISIT-TO-VISIT VARIABILITY IN BLOOD PRESSURE ON THE DEVELOPMENT OF METABOLIC SYNDROME IN THE HEALTHY POPULATI ON: A POPULATION-BASED PROSPECTIVE COHORT STUDY IN KOREA

초록

Objective: The aim of this study is to evaluate the effect of visit-to-visit variability (VVV) of blood pressure (BP) on development of metabolic syndrome (Mets) in general population without cardiovascular disease, diabetes mellitus, MetS, and BP medication. Design and method: We used data from the Korean Genome Epidemiology Study (KoGES) conducted by the Korean Centers for Disease Control and Prevention (KCDC). All cohorts who were followed first 3 periods without omission, formed the basis of the study sample, which consisted of 7195 people. Of these samples, 3431 subjects who had cardiovascular disease, diabetes mellitus, or metabolic syndrome were excluded, and 312 subjects who were using antihypertensive medication in first 3 periods were excluded. Our final study sample consisted of 3452 cohorts. Results: The mean age was 53.5 (8.25) years. The proportion of male was 50.2%. Average follow-up duration was 5.91 (± 0.17) years. In generalized estimating equation (GEE), the development of MetS was associated with mean systolic BP (SBP) (Odds ratio (OR) 1.042, 95% confidence interval (CI) 1.035 – 1.048, p < 0.001), mean diastolic BP (DBP) (OR 1.059, 95% CI 1.049 – 1.069, p < 0.001), standard deviation (SD) of SBP (OR 1.036, 95% CI 1.017 – 1.055, p < 0.001), and SD of DBP (OR 1.053, 95% CI 1.027 – 1.080, p < 0.001) after adjusted for age, sex, and MetS component. When mean SBP, mean DBP, SD of SBP, and SD of DBP were entered all together in the analysis model, mean SBP (OR 1.033, 95% CI 1.020 – 1.045, p < 0.001) and SD of DBP (OR 1.033, 95% CI 1.003 – 1.063, p = 0.030) were significantly associated with the development of MetS. Conclusions: In general population without cardiovascular disease, diabetes mellitus, MetS, and BP medication, mean SBP and VVV of DBP was associated with the development of MetS.