Projects per year
Abstract
Objectives: To explore the association of different types of blood pressure (BP) variability measures estimated from either short-term ambulatory reading-to-reading or long-term clinic visit-to-visit BP records with long-term survival in an elderly treated hypertensive population. Methods: A subset of patients (n = 508) aged at least 65-years was studied from the Second Australian National Blood Pressure study. We estimated SBP and DBP BP variability as the SD of ambulatory (24-h, daytime, night-time) and clinic visit-to-visit BP directly from all corresponding on-treatment within-individual BP records. Ambulatory 'weighted day-night' variability was calculated as a weighted mean of daytime and night-time SD. Cox-proportional hazard models adjusted for baseline risk factors (Model 1) and corresponding on-treatment BP (Model 2) or average night-time SBP (best predictive BP measure for outcome) (Model 3) were used to determine the relationship between long-term outcome and BP variability. Results: Over a median of 10.6 years, 101 patients died from any cause, of which 51 deaths were cardiovascular. We observed increase in 'daytime' and 'weighted day-night' SBP/DBP variability was significantly associated with increased all-cause mortality in all models. For cardiovascular mortality, only 'weighted day-night' SBP variability significantly predicted risk in all models (Model 3 hazard ratio: 1.09, 95% confidence interval: 1.00-1.19, P = 0.04). Long-term BP variability was not associated with any outcome. On direct comparison, both 'daytime' and 'weighted day-night' BP variability measures provided similar prognostic information. Conclusion: Short-term 'daytime' and 'weighted day-night' SBP variability from ambulatory BP recordings was a better predictor of mortality in elderly treated hypertensive patients than long-term BP variability from visit-to-visit BP recordings.
Original language | English |
---|---|
Pages (from-to) | 1059-1067 |
Number of pages | 9 |
Journal | Journal of Hypertension |
Volume | 36 |
Issue number | 5 |
DOIs | |
Publication status | Published - 1 May 2018 |
Keywords
- ambulatory blood pressure
- blood pressure variability
- cardiovascular events
- clinic blood pressure
- elderly
- hypertension
-
Prevention and treatment of chronic heart and kidney disease via epidemiological, pharmacological device and cell-based approaches
Krum, H. (Primary Chief Investigator (PCI)), Kelly, D. (Chief Investigator (CI)) & Reid, C. (Chief Investigator (CI))
NHMRC - National Health and Medical Research Council (Australia)
1/01/10 → 31/12/14
Project: Research
-
NHMRC Research Fellowship
Reid, C. (Primary Chief Investigator (PCI))
NHMRC - National Health and Medical Research Council (Australia)
1/01/08 → 3/05/16
Project: Research