Visit-to-visit variability of metabolic parameters and risk of heart failure

A nationwide population-based study

Soonil Kwon, So Ryoung Lee, Eue-Keun Choi, Seung Hwan Lee, Kyung Do Han, Seo Young Lee, Seokhun Yang, Jiesuck Park, You Jung Choi, Hyun Jung Lee, Inki Moon, Euijae Lee, Myung Jin Cha, Woo Hyun Lim, Seil Oh

Research output: Contribution to journalArticleResearchpeer-review

1 Citation (Scopus)

Abstract

Background: This study examined the effects of variability of four metabolic parameters, namely systolic blood pressure (BP), body mass index (BMI), fasting blood glucose (FBG), and total cholesterol level (TC) on the risk of HF. The effects of metabolic parameter variability on the risk of heart failure (HF) remain unclear. Methods: We studied individuals aged ≥40 years who had undergone ≥3 health check-ups under the Korean National Health Insurance Corporation during 2009 and 2012, and those who did not have hypertension, diabetes, or dyslipidemia. BP, BMI, FBG, and TC were measured at every visit. We defined the variability of each parameter using the variability independent of the mean (VIM) method. VIMs were categorized into four groups according to quartiles. The metabolic variability (MV) score for each subject was defined as the number of VIMs in the highest quartile. Results: Among the 3,820,191 subjects, 17,253 (0.45%) had incident HF during a mean 5.3 ± 1.1 years of follow-up. High variability of each parameter was associated with increased HF risk, which increased according to the MV score. After multivariable adjustment, compared to subjects with MV score = 0, subjects with MV score = 1–4 had an increased risk of HF (adjusted HR [95% CI], 1.15 [1.10–1.19] for MV score = 1, 1.33 [1.28–1.39] for MV score = 2, 1.48 [1.40–1.57] for MV score = 3, 1.74 [1.55–1.96] for MV score = 4 [p-for-trend ≪0.0001]). Conclusions: High variability of BP, BMI, FBG, and TC was synergistically associated with a higher incidence of new-onset HF.

Original languageEnglish
Pages (from-to)153-158
Number of pages6
JournalInternational Journal of Cardiology
Volume293
DOIs
StatePublished - 15 Oct 2019

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Heart Failure
Population
Blood Glucose
Fasting
Body Mass Index
Cholesterol
Blood Pressure
Hypertension
Social Adjustment
National Health Programs
Dyslipidemias
Incidence
Health

Keywords

  • Blood glucose
  • Blood pressure
  • Body mass index
  • Cholesterol
  • Heart failure

Cite this

Kwon, Soonil ; Lee, So Ryoung ; Choi, Eue-Keun ; Lee, Seung Hwan ; Han, Kyung Do ; Lee, Seo Young ; Yang, Seokhun ; Park, Jiesuck ; Choi, You Jung ; Lee, Hyun Jung ; Moon, Inki ; Lee, Euijae ; Cha, Myung Jin ; Lim, Woo Hyun ; Oh, Seil. / Visit-to-visit variability of metabolic parameters and risk of heart failure : A nationwide population-based study. In: International Journal of Cardiology. 2019 ; Vol. 293. pp. 153-158.
@article{db60ce38fc844918ab8cb2292c1529f4,
title = "Visit-to-visit variability of metabolic parameters and risk of heart failure: A nationwide population-based study",
abstract = "Background: This study examined the effects of variability of four metabolic parameters, namely systolic blood pressure (BP), body mass index (BMI), fasting blood glucose (FBG), and total cholesterol level (TC) on the risk of HF. The effects of metabolic parameter variability on the risk of heart failure (HF) remain unclear. Methods: We studied individuals aged ≥40 years who had undergone ≥3 health check-ups under the Korean National Health Insurance Corporation during 2009 and 2012, and those who did not have hypertension, diabetes, or dyslipidemia. BP, BMI, FBG, and TC were measured at every visit. We defined the variability of each parameter using the variability independent of the mean (VIM) method. VIMs were categorized into four groups according to quartiles. The metabolic variability (MV) score for each subject was defined as the number of VIMs in the highest quartile. Results: Among the 3,820,191 subjects, 17,253 (0.45{\%}) had incident HF during a mean 5.3 ± 1.1 years of follow-up. High variability of each parameter was associated with increased HF risk, which increased according to the MV score. After multivariable adjustment, compared to subjects with MV score = 0, subjects with MV score = 1–4 had an increased risk of HF (adjusted HR [95{\%} CI], 1.15 [1.10–1.19] for MV score = 1, 1.33 [1.28–1.39] for MV score = 2, 1.48 [1.40–1.57] for MV score = 3, 1.74 [1.55–1.96] for MV score = 4 [p-for-trend ≪0.0001]). Conclusions: High variability of BP, BMI, FBG, and TC was synergistically associated with a higher incidence of new-onset HF.",
keywords = "Blood glucose, Blood pressure, Body mass index, Cholesterol, Heart failure",
author = "Soonil Kwon and Lee, {So Ryoung} and Eue-Keun Choi and Lee, {Seung Hwan} and Han, {Kyung Do} and Lee, {Seo Young} and Seokhun Yang and Jiesuck Park and Choi, {You Jung} and Lee, {Hyun Jung} and Inki Moon and Euijae Lee and Cha, {Myung Jin} and Lim, {Woo Hyun} and Seil Oh",
year = "2019",
month = "10",
day = "15",
doi = "10.1016/j.ijcard.2019.06.035",
language = "English",
volume = "293",
pages = "153--158",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

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Kwon, S, Lee, SR, Choi, E-K, Lee, SH, Han, KD, Lee, SY, Yang, S, Park, J, Choi, YJ, Lee, HJ, Moon, I, Lee, E, Cha, MJ, Lim, WH & Oh, S 2019, 'Visit-to-visit variability of metabolic parameters and risk of heart failure: A nationwide population-based study', International Journal of Cardiology, vol. 293, pp. 153-158. https://doi.org/10.1016/j.ijcard.2019.06.035

Visit-to-visit variability of metabolic parameters and risk of heart failure : A nationwide population-based study. / Kwon, Soonil; Lee, So Ryoung; Choi, Eue-Keun; Lee, Seung Hwan; Han, Kyung Do; Lee, Seo Young; Yang, Seokhun; Park, Jiesuck; Choi, You Jung; Lee, Hyun Jung; Moon, Inki; Lee, Euijae; Cha, Myung Jin; Lim, Woo Hyun; Oh, Seil.

In: International Journal of Cardiology, Vol. 293, 15.10.2019, p. 153-158.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Visit-to-visit variability of metabolic parameters and risk of heart failure

T2 - A nationwide population-based study

AU - Kwon, Soonil

AU - Lee, So Ryoung

AU - Choi, Eue-Keun

AU - Lee, Seung Hwan

AU - Han, Kyung Do

AU - Lee, Seo Young

AU - Yang, Seokhun

AU - Park, Jiesuck

AU - Choi, You Jung

AU - Lee, Hyun Jung

AU - Moon, Inki

AU - Lee, Euijae

AU - Cha, Myung Jin

AU - Lim, Woo Hyun

AU - Oh, Seil

PY - 2019/10/15

Y1 - 2019/10/15

N2 - Background: This study examined the effects of variability of four metabolic parameters, namely systolic blood pressure (BP), body mass index (BMI), fasting blood glucose (FBG), and total cholesterol level (TC) on the risk of HF. The effects of metabolic parameter variability on the risk of heart failure (HF) remain unclear. Methods: We studied individuals aged ≥40 years who had undergone ≥3 health check-ups under the Korean National Health Insurance Corporation during 2009 and 2012, and those who did not have hypertension, diabetes, or dyslipidemia. BP, BMI, FBG, and TC were measured at every visit. We defined the variability of each parameter using the variability independent of the mean (VIM) method. VIMs were categorized into four groups according to quartiles. The metabolic variability (MV) score for each subject was defined as the number of VIMs in the highest quartile. Results: Among the 3,820,191 subjects, 17,253 (0.45%) had incident HF during a mean 5.3 ± 1.1 years of follow-up. High variability of each parameter was associated with increased HF risk, which increased according to the MV score. After multivariable adjustment, compared to subjects with MV score = 0, subjects with MV score = 1–4 had an increased risk of HF (adjusted HR [95% CI], 1.15 [1.10–1.19] for MV score = 1, 1.33 [1.28–1.39] for MV score = 2, 1.48 [1.40–1.57] for MV score = 3, 1.74 [1.55–1.96] for MV score = 4 [p-for-trend ≪0.0001]). Conclusions: High variability of BP, BMI, FBG, and TC was synergistically associated with a higher incidence of new-onset HF.

AB - Background: This study examined the effects of variability of four metabolic parameters, namely systolic blood pressure (BP), body mass index (BMI), fasting blood glucose (FBG), and total cholesterol level (TC) on the risk of HF. The effects of metabolic parameter variability on the risk of heart failure (HF) remain unclear. Methods: We studied individuals aged ≥40 years who had undergone ≥3 health check-ups under the Korean National Health Insurance Corporation during 2009 and 2012, and those who did not have hypertension, diabetes, or dyslipidemia. BP, BMI, FBG, and TC were measured at every visit. We defined the variability of each parameter using the variability independent of the mean (VIM) method. VIMs were categorized into four groups according to quartiles. The metabolic variability (MV) score for each subject was defined as the number of VIMs in the highest quartile. Results: Among the 3,820,191 subjects, 17,253 (0.45%) had incident HF during a mean 5.3 ± 1.1 years of follow-up. High variability of each parameter was associated with increased HF risk, which increased according to the MV score. After multivariable adjustment, compared to subjects with MV score = 0, subjects with MV score = 1–4 had an increased risk of HF (adjusted HR [95% CI], 1.15 [1.10–1.19] for MV score = 1, 1.33 [1.28–1.39] for MV score = 2, 1.48 [1.40–1.57] for MV score = 3, 1.74 [1.55–1.96] for MV score = 4 [p-for-trend ≪0.0001]). Conclusions: High variability of BP, BMI, FBG, and TC was synergistically associated with a higher incidence of new-onset HF.

KW - Blood glucose

KW - Blood pressure

KW - Body mass index

KW - Cholesterol

KW - Heart failure

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U2 - 10.1016/j.ijcard.2019.06.035

DO - 10.1016/j.ijcard.2019.06.035

M3 - Article

VL - 293

SP - 153

EP - 158

JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

ER -