Within-subject blood pressure level--not variability--predicts fatal and nonfatal outcomes in a general population
| Autor: | Augustine N. Odili, Kei Asayama, Jan A. Staessen, Yu-Mei Gu, Rudolph Schutte, Lutgarde Thijs, Yu Jin, Yan-Ping Liu, Tatiana Kuznetsova, Lotte Jacobs |
|---|---|
| Přispěvatelé: | Cardiologie, Epidemiologie, Genetica & Celbiologie, RS: CARIM School for Cardiovascular Diseases, 12201405 - Schutte, Rudolph |
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Blood pressure variability
Adult Male medicine.medical_specialty Multivariate analysis Population Adrenergic beta-Antagonists Blood Pressure 030204 cardiovascular system & hematology Risk Assessment Article 03 medical and health sciences Young Adult 0302 clinical medicine Belgium population science cardiovascular disease Internal medicine Epidemiology Outcome Assessment Health Care Internal Medicine Medicine Humans risk factors Mass index 030212 general & internal medicine Young adult education Survival rate 2. Zero hunger education.field_of_study business.industry Hazard ratio Blood Pressure Determination Middle Aged Prognosis 3. Good health Surgery Survival Rate Blood pressure Cardiovascular Diseases Multivariate Analysis Cardiology Female epidemiology blood pressure variability business Follow-Up Studies |
| Zdroj: | Hypertension; Vol 60 Hypertension, 60(5). LIPPINCOTT WILLIAMS & WILKINS |
| ISSN: | 0194-911X |
| Popis: | To assess the prognostic significance of blood pressure (BP) variability, we followed health outcomes in a family-based random population sample representative of the general population (n=2944; mean age: 44.9 years; 50.7% women). At baseline, BP was measured 5 times consecutively at each of 2 home visits 2 to 4 weeks apart. We assessed within-subject overall (10 readings), within- and between-visit systolic BP variability from variability independent of the mean, the difference between maximum and minimum BP, and average real variability. Over a median follow-up of 12 years, 401 deaths occurred and 311 participants experienced a fatal or nonfatal cardiovascular event. Overall systolic BP variability averaged (SD) 5.45 (2.82) units, 15.87 (8.36) mmHg, and 4.08 (2.05) mmHg for variability independent of the mean, difference between maximum and minimum BP, and average real variability, respectively. Female sex, older age, higher-mean systolic BP, lower body mass index, a history of peripheral arterial disease, and use of β-blockers were the main correlates of systolic BP variability. In multivariable-adjusted analyses, overall and within- and between-visit BP variability did not predict total or cardiovascular mortality or the composite of any fatal plus nonfatal cardiovascular end point. For instance, the hazard ratios for all cardiovascular events combined in relation to overall variability independent of the mean, difference between maximum and minimum BP, and average real variability were 1.05 (0.96–1.15), 1.06 (0.96–1.16), and 1.08 (0.98–1.19), respectively. By contrast, mean systolic BP was a significant predictor of all end points under study, independent of BP variability. In conclusion, in an unbiased population sample, BP variability did not contribute to risk stratification over and beyond mean systolic BP. http://dx.doi.org/10.1161/HYPERTENSIONAHA.112.202143 http://hyper.ahajournals.org/content/60/5/1138.full.pdf+html |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|