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Blood pressure vari...
Blood pressure variability predicts cardiovascular events independently of traditional cardiovascular risk factors and target organ damage : a LIFE substudy
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- Vishram, Julie K.K. (author)
- Research Centre for Prevention and Health, Glostrup University Hospital, Glostrup, Denmark; Department of Internal Medicine, Næstved Hospital, Næstved, Denmark
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- Dahlöf, Björn, 1953 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Devereux, Richard B. (author)
- Weill Medical College of Cornell University, NY, New York, United States
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- Ibsen, Hans (author)
- Division of Cardiology, Holbæk University Hospital, Holbæk, Denmark
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- Kjeldsen, Sverre E. (author)
- Ullevaal University Hospital, Oslo, Norway
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- Lindholm, Lars H. (author)
- Umeå University Hopsital, Umeå, Sweden
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- Mancia, Giuseppe (author)
- University of Milano-Bicocca, IRCCS Istituto Auxologico Italiano, Milan, Italy
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- Okin, Peter M. (author)
- Weill Medical College of Cornell University, NY, New York, United States
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- Rothwell, Peter M. (author)
- Stroke Prevention Research Unit, University Department of Clinical Neurology, John Radcliffe Hospital, West Wing, Headington, Oxford, United Kingdom
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- Wachtell, Kristian (author)
- Department of Internal Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark
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- Olsen, Michael H. (author)
- Cardiovascular and Metabolic Preventive Clinic, Department of Endocrinology, Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, Denmark; Hypertension in Africa Research Team (HART), North-West University, Mahikeng, South Africa
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(creator_code:org_t)
- Lippincott Williams & Wilkins, 2015
- 2015
- English.
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In: Journal of Hypertension. - : Lippincott Williams & Wilkins. - 0263-6352 .- 1473-5598. ; 33:12, s. 2422-2430
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background: Assessment of antihypertensive treatment is normally based on the mean value of a number of blood pressure (BP) measurements. However, it is uncertain whether high in-treatment visit-to-visit BP variability may be harmful in hypertensive patients with left ventricular hypertrophy (LVH).Methods: In 8505 patients randomized to losartan vs. atenolol-based treatment in the LIFE study, we tested whether BP variability assessed as SD and range for BP6-24months measured at 6, 12, 18 and 24 months of treatment was associated with target organ damage (TOD) defined by LVH on ECG and urine albumin/creatinine ratio at 24 months, and predicted the composite endpoint (CEP) of cardiovascular death, nonfatal myocardial infarction (MI) or stroke occurring after 24 months (CEP=630 events).Results: In multiple regression models adjusted for mean BP6-24months and treatment allocation, neither high BP6-24months SD nor wide range were related to TOD at 24 months, except for a weak association between Sokolow-Lyon voltage and DBP6-24months SD and range (both b=0.04, P<0.01). Independently of mean BP6-24months, treatment allocation, TOD and baseline characteristics in Cox regression models, CEP after 24 months was associated with DBP6-24months SD [hazard ratio per 1mmHg increase1.04, 95% confidence interval (95% CI) 1.01-1.06, P=0.005], range (hazard ratio 1.02, 95% CI 1.01-1.03, P=0.004), SBP6-24months SD (hazard ratio 1.01, 95% CI 0.99-1.02, P=0.07) and range (hazard ratio 1.006, 95% CI 1.001-1.01, P=0.04). Adjusted for the same factors, stroke was associated with DBP6-24months SD (hazard ratio 1.06, 95% CI 1.02-1.10, P=0.001), range (hazard ratio 1.03, 95% CI 1.01-1.04, P=0.001), SBP6-24months SD (hazard ratio 1.02, 95% CI 1.002-1.04, P=0.04) and range (hazard ratio 1.008, 95% CI 1.001-1.02, P=0.05), but MI was not.Conclusion: In LIFE patients, higher in-treatment BP6-24months variability was independently of mean BP6-24months associated with later CEP and stroke, but not with MI or TOD after 24 months.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- blood pressure variability
- cardiovascular risk
- epidemiology
- target organ damage
- blood pressure variability
- cardiovascular risk
- epidemiology
- target organ damage
Publication and Content Type
- ref (subject category)
- art (subject category)
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Vishram, Julie K ...
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Dahlöf, Björn, 1 ...
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Devereux, Richar ...
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Ibsen, Hans
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Kjeldsen, Sverre ...
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Lindholm, Lars H ...
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Mancia, Giuseppe
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Okin, Peter M.
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Rothwell, Peter ...
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Wachtell, Kristi ...
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Olsen, Michael H ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and General Practice
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MEDICAL AND HEAL ...
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Journal of Hyper ...
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Umeå University
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University of Gothenburg