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Prognostic value of reading-to-reading blood pressure variability over 24 hours in 8938 subjects from 11 populations
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2010 (English)In: Hypertension, ISSN 0194-911X, E-ISSN 1524-4563, Vol. 55, no 4, 1049-1057 p.Article in journal (Refereed) Published
Abstract [en]

In previous studies, of which several were underpowered, the relation between cardiovascular outcome and blood pressure (BP) variability was inconsistent. We followed health outcomes in 8938 subjects (mean age: 53.0 years; 46.8% women) randomly recruited from 11 populations. At baseline, we assessed BP variability from the SD and average real variability in 24-hour ambulatory BP recordings. We computed standardized hazard ratios (HRs) while stratifying by cohort and adjusting for 24-hour BP and other risk factors. Over 11.3 years (median), 1242 deaths (487 cardiovascular) occurred, and 1049, 577, 421, and 457 participants experienced a fatal or nonfatal cardiovascular, cardiac, or coronary event or a stroke. Higher diastolic average real variability in 24-hour ambulatory BP recordings predicted (Por=1.07) with the exception of cardiac and coronary events (HR: or=0.58). Higher systolic average real variability in 24-hour ambulatory BP recordings predicted (P<0.05) total (HR: 1.11) and cardiovascular (HR: 1.16) mortality and all fatal combined with nonfatal end points (HR: >or=1.07), with the exception of cardiac and coronary events (HR: or=0.54). SD predicted only total and cardiovascular mortality. While accounting for the 24-hour BP level, average real variability in 24-hour ambulatory BP recordings added <1% to the prediction of a cardiovascular event. Sensitivity analyses considering ethnicity, sex, age, previous cardiovascular disease, antihypertensive treatment, number of BP readings per recording, or the night:day BP ratio were confirmatory. In conclusion, in a large population cohort, which provided sufficient statistical power, BP variability assessed from 24-hour ambulatory recordings did not contribute much to risk stratification over and beyond 24-hour BP.

Place, publisher, year, edition, pages
2010. Vol. 55, no 4, 1049-1057 p.
Keyword [en]
Ambulatory blood pressure, Blood pressure variability, Epidemiology, Population science, Risk factors
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-135250DOI: 10.1161/HYPERTENSIONAHA.109.140798ISI: 000275701600038PubMedID: 20212270OAI: oai:DiVA.org:uu-135250DiVA: diva2:374724
Available from: 2010-12-06 Created: 2010-12-06 Last updated: 2017-12-11Bibliographically approved

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