Variable Weight, BP, Cholesterol Raises Risk of Heart Attack

High variability in weight, blood pressure (BP), cholesterol, and blood sugar levels in otherwise healthy individuals could predict mortality and cardiovascular events, according to the results of a recent study.

Variability in metabolic parameters has been shown to have an effect on health outcomes, but whether they have an additive effect on mortality risk and cardiovascular outcomes in the general population is less well understood.

Using nationally representative data from the Korean National Health Insurance System, the researchers followed 6,748,773 patients who underwent 3 or more health examinations from 2005 to 2012. Coefficient of variation, standard deviation (SD), variability independent of the mean, and average real variability were used to measure variability in fasting blood glucose, total cholesterol, systolic blood pressure, and BMI. The participants were scored based on how many metabolic parameters showed variability.

Overall, 54,785 deaths occurred, as well as 22,498 strokes and 21,452 myocardial infarctions during 5.5 years of follow-up.

High variability in any of the parameters was associated with a higher risk of all-cause mortality, myocardial infarction, and stroke. Further, the risk increased significantly with each additional high-variability metabolic parameter (hazard ratios comparing 0 to 4 variable parameters: 2.27 for all-cause mortality, 1.43 for myocardial infarction, and 1.41 for stroke).

“High variability of fasting blood glucose and total cholesterol levels, systolic blood pressure, and body mass index was an independent predictor of mortality and cardiovascular events. There was a graded association between the number of high-variability parameters and cardiovascular outcomes.”

—Michael Potts

Reference:

Kim MK, Han K, Park Y et al. Associations of variability in blood pressure, glucose and cholesterol concentrations, and body mass index with mortality and cardiovascular outcomes in the general population [published online October 1, 2018]. Circulation. doi: 10.1161/CIRCULATIONAHA.118.034978