Systolic blood pressure variability and lower extremity amputation in a non-elderly population with diabetes

Abstract Objective Systolic blood pressure (SBP) variability is emerging as a new risk factor for cardiovascular diseases, diabetic nephropathy, and other atherosclerotic conditions. Our objective is to examine whether it has any prognostic value for lower-extremity amputations. Research design and methods This is a nested case-control study of a cohort of patients with diabetes aged  Results The study sample included 1038 cases and 2932 controls. Compared to Quartile 1 (lowest variability), Quartile 2 had 1.4 times (OR = 1.44, 95% CI = 1.00–2.07) and Quartiles 3 and 4 (highest) had 2.5 times (OR for Quartile 3 = 2.62, 95% CI = 1.85–3.72; OR for Quartile 4 = 2.50, 95% CI = 1.74–3.59) higher risk of major amputation ( P for trend  Conclusions This is the first study to show a significant graded relationship between SBP variability and risk of major amputation among non-elderly persons with diabetes.