Short-term blood pressure variability, arterial stiffness, and cardiovascular events: results from the Bordeaux cohort
| Autor: | Philippe Gosse, Christophe Tzourio, Antoine Cremer, Romain Boulestreau, Julien Doublet, Julie Gaudissard |
|---|---|
| Přispěvatelé: | Bordeaux population health (BPH), Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM) |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Ambulatory blood pressure Adolescent Physiology Population Blood Pressure 030204 cardiovascular system & hematology Bedtime Cohort Studies 03 medical and health sciences Vascular Stiffness 0302 clinical medicine Risk Factors Internal medicine Internal Medicine medicine Humans 030212 general & internal medicine Korotkoff sounds 10. No inequality education education.field_of_study business.industry Blood Pressure Monitoring Ambulatory medicine.disease Blood pressure Hypertension Ambulatory Cohort Cardiology Arterial stiffness [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Hypertension Journal of Hypertension, Lippincott, Williams & Wilkins, 2021, ⟨10.1097/hjh.0000000000002735⟩ |
| ISSN: | 1473-5598 0263-6352 |
| DOI: | 10.1097/hjh.0000000000002735 |
| Popis: | Objective Short-term blood pressure variability derived from 24-h ambulatory monitoring is associated with poor cardiovascular prognosis. However, previous analyses of this have clearly been influenced by clinical cofounders, particularly blood pressure (BP) level. Arterial stiffness is a powerful marker of cardiovascular risk, which may influence BP variability. In this study, we assessed the prognostic value of BP variability based on 24-h ambulatory measurements and adjusted for arterial stiffness. Methods Population: Bordeaux cohort of hypertensive patients. Inclusion criteria were 24-h ambulatory BP monitoring at baseline with measurements every 15' day and night, determination of wake-up time and bedtime, and assessment of arterial stiffness with monitoring of Korotkoff sound arrival time. A total of 969 patients (age 54 ± 14 years) with an average follow up of 120 ± 78 months and 178 cardiovascular recorded events were included. Results In univariate survival analyses, the standard deviations of day, night, and 24-h SBP were associated with the occurrence of cardiovascular events. The standard deviation of night-time SBP showed the strongest association with the outcome variable and was entered into multivariate analyses. In multivariate analyses, night-time SBP variability remained significantly associated with the occurrence of cardiovascular events after adjusting for major cardiovascular risk factors, 24-h SBP, and arterial stiffness. BP variability and arterial stiffness showed no significant association. Conclusion Our results suggest that variability of night-time SBP is an important marker of the risk of cardiovascular events in hypertensive patients, independently of average 24-h BP and arterial stiffness. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|