Visit-to-visit (long-term) and ambulatory (short-term) blood pressure variability to predict mortality in an elderly hypertensive population.
In: Journal of hypertension, Jg. 36 (2018-05-01), Heft 5, S. 1059-1067
Online
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Zugriff:
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.
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Visit-to-visit (long-term) and ambulatory (short-term) blood pressure variability to predict mortality in an elderly hypertensive population.
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Autor/in / Beteiligte Person: | Chowdhury, EK ; Wing, LMH ; Jennings, GLR ; Beilin, LJ ; Reid, CM |
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Zeitschrift: | Journal of hypertension, Jg. 36 (2018-05-01), Heft 5, S. 1059-1067 |
Veröffentlichung: | [Alphen aan den Rijn, the Netherlands] : Wolters Kluwer Health, Inc. ; <i>Original Publication</i>: London ; New York : Gower Academic Pub., [1983-, 2018 |
Medientyp: | academicJournal |
ISSN: | 1473-5598 (electronic) |
DOI: | 10.1097/HJH.0000000000001652 |
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