Prognostic Value of Reading-to-Reading Blood Pressure Variability Over 24 Hours in 8938 Subjects From 11 Populations

Tine W. Hansen, Lutgarde Thijs, Yan Li, Jose Boggia, Masahiro Kikuya, Kristina Bjorklund-Bodegard, Tom Richart, Takayoshi Ohkubo, Jorgen Jeppesen, Christian Torp-Pedersen, Eamon Dolan, Tatiana Kuznetsova, Katarzyna Stolarz-Skrzypek, Valerie Tikhonoff, Sofia Malyutina, Edoardo Casiglia, Yuri Nikitin, Lars Lind, Edgardo Sandoya, Kalina Kawecka-JaszczYutaka Imai, Jiguang Wang, Hans Ibsen, Eoin O'Brien, Jan A. Staessen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

320 Citations (Web of Science)

Abstract

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 (P = 1.07) with the exception of cardiac and coronary events (HR: = 0.58). Higher systolic average real variability in 24-hour ambulatory BP recordings predicted (P= 1.07), with the exception of cardiac and coronary events (HR: = 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
Original languageEnglish
Pages (from-to)1049-U419
JournalHypertension
Volume55
Issue number4
DOIs
Publication statusPublished - Apr 2010

Keywords

  • blood pressure variability
  • ambulatory blood pressure
  • population science
  • risk factors
  • epidemiology

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