scholarly journals The impact of systolic and diastolic blood pressure variability on mortality is age dependent: Data from the Dublin Outcome Study

2019 ◽  
Vol 27 (4) ◽  
pp. 355-364 ◽  
Author(s):  
Grzegorz Bilo ◽  
Eamon Dolan ◽  
Eoin O'Brien ◽  
Rita Facchetti ◽  
Davide Soranna ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Confidence Interval ◽  
Diastolic Blood Pressure ◽  
Cardiovascular Mortality ◽  
Blood Pressure Variability ◽  
Strong Predictor ◽  
Outcome Study ◽  
Short Term ◽  
The Impact

Background Twenty-four-hour blood pressure variability (BPV) is independently related to cardiovascular outcomes, but limited and conflicting evidence is available on the relative prognostic importance of systolic and diastolic BPV. The aim of this study was to verify the hypothesis that the association of systolic and diastolic blood pressure variability over 24 h with cardiovascular mortality in untreated subjects is affected by age. Design and methods The study included 9154 untreated individuals assessed for hypertension between 1982 and 2002 in the frame of the Dublin Outcome Study, in which 24 h ambulatory blood pressure monitoring was obtained (age 54.1 ± 14.3 years, 47% males). The association of short-term systolic and diastolic blood pressure variability with cardiovascular and all-cause mortality in the entire sample and separately in younger and older age subgroups was assessed over a median follow-up period of 6.3 years. Results Diastolic BPV was directly and independently related to cardiovascular mortality (adjusted hazard ratio (adjHR) for daytime standard deviation 1.16 (95% confidence interval 1.08–1.26)) with no significant differences among age groups. Conversely, systolic BPV was independently associated with cardiovascular mortality only in younger (<50 years) subjects (adjHR for daytime standard deviation 1.72 (95% confidence interval 1.33–2.23)), superseding the predictive value of diastolic BPV in this group. Conclusions Diastolic short-term BPV independently predicts cardiovascular mortality in hypertensive subjects at all ages, while systolic BPV seems a particularly strong predictor in young adults. If confirmed, these findings might improve the understanding of the prognostic value of BPV, with new perspectives for its possible clinical application.

scholarly journals The value of blood pressure variability in clinical practice. Opportunities of amlodipine in reducing blood pressure variability (based on the Russian program «VARIATIONS»)

2014 ◽  
Vol 11 (1) ◽  
pp. 11-16
Author(s):  
O D Ostroumova ◽  
O V Bondarets ◽  
T F Guseva
Keyword(s):  
Blood Pressure ◽  
Clinical Practice ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Short Term ◽  
Different Types ◽  
Practice Opportunities ◽  
The Impact ◽  
Dose Dependent ◽  
Russian Program

The article discusses the importance of different types of variability in blood pressure (BP) as an independent risk factor for stroke and myocardial infarction in patients with arterial hypertension. The results of the Russian observation program (1500 patients) on the impact of amlodipine show BP variability in real clinical practice. According to the results, amlodipine 5-10 mg after 2 weeks of treatment significantly reduces the variability of systolic and diastolic blood pressure in both sexes. His influence on the short-term variability in diastolic blood pressure is dose-dependent.

scholarly journals Blood Pressure Variability and Incidence of New-Onset Atrial Fibrillation

Hypertension ◽  
2020 ◽  
Vol 75 (2) ◽  
pp. 309-315 ◽  
Author(s):  
So-Ryoung Lee ◽  
You-Jung Choi ◽  
Eue-Keun Choi ◽  
Kyung-Do Han ◽  
Euijae Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Blood Pressure Measurement ◽  
Population Based ◽  
Increased Risk ◽  
Complete Set ◽  
The Impact ◽  
Fourth Quartile

Blood pressure variability is a well-known risk factor for cardiovascular disease, but its association with atrial fibrillation (AF) is uncertain. We aimed to evaluate the association between visit-to-visit blood pressure variability and incident AF. This population-based cohort study used database from the Health Screening Cohort, which contained a complete set of medical claims and a biannual health checkup information of the Koran population. A total of 8 063 922 individuals who had at least 3 health checkups with blood pressure measurement between 2004 and 2010 were collected after excluding subjects with preexisting AF. Blood pressure variability was defined as variability independence of the mean and was divided into 4 quartiles. During a mean follow-up of 6.8 years, 140 086 subjects were newly diagnosed with AF. The highest blood pressure variability (fourth quartile) was associated with an increased risk of AF (hazard ratio, 95% CI; systolic blood pressure: 1.06, 1.05–1.08; diastolic blood pressure: 1.07, 1.05–1.08) compared with the lowest (first quartile). Among subjects in the fourth quartile in both systolic and diastolic blood pressure variability, the risk of AF was 7.6% higher than those in the first quartile. Moreover, this result was consistent in both patients with or without prevalent hypertension. In subgroup analysis, the impact of high blood pressure variability on AF development was stronger in high-risk subjects, who were older (≥65 years), with diabetes mellitus or chronic kidney disease. Our findings demonstrated that higher blood pressure variability was associated with a modestly increased risk of AF.

P807Short-term versus visit-to-visit blood pressure variability as predictor of early adverse cardiovascular outcome in hypertension

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Mos ◽  
L Mos ◽  
F Saladini ◽  
A Mazzer ◽  
O Vriz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Standard Deviation ◽  
Blood Pressure Variability ◽  
Prediction Models ◽  
Prognostic Significance ◽  
Ambulatory Monitoring ◽  
Hazard Ratio ◽  
Short Term ◽  
Nocturnal Dipping

Abstract Background Blood pressure variability (BPV) has emerged as an important predictor of future cardiovascular events among hypertensive patients. However, it is not known whether BPV measured with ambulatory monitoring (short-term BPV) or computed from office visits (visit-to-visit BPV) are related to each other and carry similar prognostic significance. Purpose To investigate the association of short-term BPV and visit-to-visit BPVs with cardiovascular and renal events in a young hypertensive cohort untreated at baseline. Methods Short-term BPV was measured from 24-hour blood pressure (BP) monitoring at baseline in 1167 participants with stage 1 hypertension from the HARVEST study, aged 33.1±8.5 years. Visit-to-visit BPV was calculated from office BP measured in triplicate at each visit. Visits were made two weeks apart at baseline, and then after 1 month, 2 months, 3 months, 6 months, and 1 year. Only untreated subjects were taken into account for the analysis. Hazard ratios for short-term (weighted 24-hour BP Standard Deviation) and visit-to-visit Standard Deviation were computed, adjusting for the corresponding average BP, age, sex, body mass index, 24h heart rate, smoking, alcohol and coffee consumption, physical activity, parental cardiovascular disease, glucose, total cholesterol, HDL-cholesterol, and nocturnal BP dipping. Results Short-term systolic BPV showed a weak correlation with visit-to-visit BPV (p=0.018). No correlation was found for diastolic BPVs. Independent predictors of short-term BPV were average 24h BP, smoking, and nocturnal dipping. Predictors of visit-to-visit BPV were average office BP, parental cardiovascular disease, female gender, and nocturnal dipping. During a 15.4-year follow-up, 95 end-points were observed. In a parsimonious multivariable Cox model, short-term systolic BPV (p=0.03) was an independent predictor of the endpoints with a 7% increase in risk for each 1 mmHg increment in systolic BPV. The hazard ratio for a short-term systolic BPV ≥12.8 mmHg was 2.03 (95% CI, 1.34–3.05, p=0.0007). This threshold value was identified by ROC curve analysis. The association was particularly strong for coronary events (N=41) with a hazard ratio of 3.45 (95% CI, 1.73–6.89, p=0.0004). No independent association with outcome was found for visit-to-visit systolic or diastolic BPV (p>0.66). Similar results were obtained when average real variability was used instead of standard deviation as a metric of visit-to-visit BPV (p>0.15). Conclusions These data show that in untreated young hypertensive people short-term BPV and visit-to-visit BPV have a weak relationship and a different clinical significance. Only short-term BPV measured with ambulatory monitoring improved traditional risk prediction models in this setting. Acknowledgement/Funding Associazione 18 maggio 1370

Within-Visit Blood Pressure Variability in an Unselected Adult Population

2021 ◽  
Vol 34 (10) ◽  
pp. 1125-1126
Author(s):  
Xin Chen ◽  
Shao-kun Xu ◽  
Yan Li ◽  
Zhe Hu ◽  
Hong-yu Wang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Coefficient Of Variation ◽  
Blood Pressure Variability ◽  
Adult Population ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Pressure Measurements

Abstract Background To investigate blood pressure variability among 3 successive blood pressure measurements in an unselected nationwide population in China. Methods A total of 77,549 participants were included from measurements in May 2017 in China. Blood pressure was measured 3 times consecutively with a half minute interval. Blood pressure variability was estimated with the standard deviation and coefficient of variation of the systolic and diastolic blood pressure. Results Not all participants showed a decreasing trend with increasing number of measurements. In fact, 14% of the participants showed at least 5 mm Hg increase in systolic blood pressure. The coefficient of variation of systolic and diastolic blood pressure in women was higher than in men [(4.2 ± 3.3)% vs. (4.1 ± 3.3)%, (4.7 ± 4.0)% vs. (4.6 ± 4.1)%; P &lt; 0.05]. The differences were significant (P &lt; 0.01) among different groups of age and blood pressure levels. Multiple linear regression analysis showed that the systolic blood pressure variability indexes were inversely associated with age but positively associated with the level of the first systolic blood pressure reading (P &lt; 0.01). The systolic blood pressure standard deviation and coefficient of variation in females were higher than in males (P &lt; 0.01). Conclusions Not all subjects demonstrate a decreasing trend with increasing number of blood pressure measurements. Within-visit blood pressure variability varies with age, gender, and blood pressure.

scholarly journals Association of short-term blood pressure variability with cardiovascular mortality among incident hemodialysis patients

Renal Failure ◽  
2018 ◽  
Vol 40 (1) ◽  
pp. 259-264 ◽  
Author(s):  
Yiduo Feng ◽  
Ziqian Li ◽  
Jing Liu ◽  
Fang Sun ◽  
Lijie Ma ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Mortality ◽  
Blood Pressure Variability ◽  
Hemodialysis Patients ◽  
Short Term

Correlation Between Serum Total Bilirubin Levels and Blood Pressure Variability in Patients With Hypertension

2021 ◽  
Vol 34 (9) ◽  
pp. 1009-1010
Author(s):  
Jun Wang ◽  
Ya-nan Xu ◽  
Long Tang ◽  
Jing-shui Zhang ◽  
Zhen Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Standard Deviation ◽  
Linear Regression ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Blood Pressure Variability ◽  
Total Bilirubin ◽  
Serum Total Bilirubin ◽  
Hypertensive Patients ◽  
Pressure Standard

Abstract Background To investigate the effect of serum total bilirubin levels on blood pressure and its variability in patients with hypertension. Methods This study was a retrospective observational study. A total of 189 subjects were recruited from September 2019 to March 2020. All hypertensive patients were scheduled for ambulatory blood pressure and a 24-hour dynamic electrocardiography. Standard deviations of 24-hour systolic and diastolic blood pressure were used as blood pressure variability indicators. A multiple linear regression was used to analyze the relationship between total bilirubin serum levels and blood pressure variability in hypertensive patients. Results All patients were divided into 3 groups according to tertile values of total bilirubin: low (≤12.2 µmol/l, n = 64), moderate (12.3–16.7 µmol/l, n = 64), and high (&gt;16.8 µmol/l, n = 62) total bilirubin groups. Compared with low total bilirubin group, 24-hour mean systolic and diastolic blood pressure, 24-hour systolic blood pressure standard deviation, systolic blood pressure coefficient of variability, and 24-hour systolic blood pressure load were reduced in the moderate and high total bilirubin groups (all P &lt; 0.05). Multiple linear regression analysis showed that female (B = −1.408, P = 0.013), age (B = 0.043, P = 0.035), diabetes (B = 2.624, P &lt; 0.001), and moderate and high bilirubin grouping (B = −1.582, −3.079; both P &lt; 0.05) were influencing factors of 24-hour systolic pressure standard deviation. Serum total bilirubin levels had no effect on the standard deviation of 24-hour diastolic blood pressure(P &gt; 0.05). Conclusions In hypertensive patients, the total bilirubin serum level is an influencing factor for 24-hour systolic blood pressure variability.

scholarly journals Association Between Blood Pressure Variability and Short-Term Outcome After Intra-arterial Thrombectomy in Acute Stroke Patients With Large-Vessel Occlusion

2021 ◽  
Vol 11 ◽  
Author(s):  
Mengqi Yang ◽  
Tao Lu ◽  
Baohui Weng ◽  
Yi He ◽  
Hong Yang
Keyword(s):  
Blood Pressure ◽  
Confidence Interval ◽  
Acute Stroke ◽  
Blood Pressure Variability ◽  
Large Vessel Occlusion ◽  
Stroke Patients ◽  
Short Term ◽  
Vessel Occlusion ◽  
Term Outcome ◽  
Short Term Outcome

The optimal range of blood pressure variability (BPV) for acute stroke patients with large-vessel occlusion (LVO) remains unclear. This study investigated the association between BPV from admission through the first 24 h after intra-arterial thrombectomy (IAT) and short-term outcome in LVO patients. We retrospectively analyzed 257 consecutive patients with LVO stroke who were treated with IAT. BP values were recorded at 2-h intervals from admission through the first 24 h after IAT. BPV, as reflected by pulse pressure variability (PPV), was determined based on standard deviation (SD), coefficient of variation (CV), successive variation (SV), and the difference between maximum and minimum blood pressure (ΔBP; systolic BP minus diastolic BP). The association between BPV and clinical outcome (Modified Rankin Scale score at 90 days) was analyzed by multivariate logistic regression analysis. Of the 257 included patients, 70 had a good outcome at 3 months. PPV from admission through the first 24 h after IAT was independently associated in a graded manner with poor outcome [multivariable-adjusted odds ratios (95% confidence interval) for the highest of PPV were 43.0 (8.7–212.8) for SD, 40.3 (9.8–165.0) for CV, 55.0 (11.2–271.2) for SV, and 40.1 (8.0–201.9) for ΔBP]. The area under the receiver operating characteristic curve (95% confidence interval) of the PPV parameters were 0.924 (0.882–0.965) for SD, 0.886 (0.835–0.938) for CV, 0.932 (0.891–0.973) for SV, and 0.892 (0.845–0.939) for ΔBP, and the Youden index values were 0.740, 0.633, 0.759, and 0.756, respectively. In summary, BPV from admission through the first 24 h after IAT was independently associated with poor outcome at 3 months in patients with LVO, with greater variability corresponding to a stronger association. Thus, PPV may be a clinically useful predictor of functional prognosis in LVO patients treated with IAT.

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