Introduction and objective: Blood pressure variability (BPV) within 24 h or between visits has been found to represent an independent risk factor for cardiovascular disease. The present study was aimed at determining whether a clinical significance can be given also to the BP variations occurring within a single clinical visit. Methods: BPV was quantified as coefficient of variation and as standard deviation (SD) of the mean of three systolic SBP values within a visit in the context of a largecross subclinical survey (BP-CARE) of treated hypertensive patients living in Eastern European countries. The study population was divided into coefficient of variation and SD quartiles and for each quartile a relationship was sought with a large number of cardiovascular risk factors based on patients' history, physical and laboratory examinations. Results: The 6425 hypertensive patients had an age of 59.2±11 years (mean±SD); they were equally distributed by sex and displayed an average SD and coefficient of variation amounting to 5.1±6.2mmHg and 3.5±4.0%, respectively. Compared with the lowest coefficient of variation quartile (Q1), patients in the highest quartile (Q4) showed a significantly greater prevalence of several cardiovascular risk factors, such as age (Q1: 58.5±11 vs. Q4: 60.3±11 years, P<0.001), serum total cholesterol (Q1: 213.0±46 vs. Q4: 216.4±51 mg/dl, P<0.05), blood glucose (Q1: 106.2±35 vs. Q4: 109.8±39 mg/dl, P<0.005), previous cardiovascular events (Q1: 57.4 vs. Q4: 63.9%, P<0.001), and resistant hypertension (Q1: 26.3 vs. Q4: 34.1%, P<0.001). They also showed higher office (Q1: 143.2±18 vs. Q4: 154.3±19 mmHg, P<0.001) and 24-h ambulatory SBP values (Q1: 134.8±17 vs. Q4: 141.2±18 mmHg, P<0.001). Similar results were obtained when BPV was expressed as SD. Conclusion: Our study provides evidence that greater within-visit BP variabilities are associated with a worse cardiovascular risk profile. This suggests that even this type of BPV may have clinical significance.
Grassi, G., Seravalle, G., Maloberti, A., Facchetti, R., Cuspidi, C., Bombelli, M., et al. (2015). Within-visit BP variability, cardiovascular risk factors, and BP control in central and eastern Europe: Findings from the BP-CARE study. JOURNAL OF HYPERTENSION, 33(11), 2250-2256 [10.1097/HJH.0000000000000700].
Within-visit BP variability, cardiovascular risk factors, and BP control in central and eastern Europe: Findings from the BP-CARE study
GRASSI, GUIDO
Primo
;SERAVALLE, GINO LUCIANOSecondo
;MALOBERTI, ALESSANDRO;FACCHETTI, RITA LUCIA;CUSPIDI, CESARE;BOMBELLI, MICHELE;MANCIA, GIUSEPPEUltimo
2015
Abstract
Introduction and objective: Blood pressure variability (BPV) within 24 h or between visits has been found to represent an independent risk factor for cardiovascular disease. The present study was aimed at determining whether a clinical significance can be given also to the BP variations occurring within a single clinical visit. Methods: BPV was quantified as coefficient of variation and as standard deviation (SD) of the mean of three systolic SBP values within a visit in the context of a largecross subclinical survey (BP-CARE) of treated hypertensive patients living in Eastern European countries. The study population was divided into coefficient of variation and SD quartiles and for each quartile a relationship was sought with a large number of cardiovascular risk factors based on patients' history, physical and laboratory examinations. Results: The 6425 hypertensive patients had an age of 59.2±11 years (mean±SD); they were equally distributed by sex and displayed an average SD and coefficient of variation amounting to 5.1±6.2mmHg and 3.5±4.0%, respectively. Compared with the lowest coefficient of variation quartile (Q1), patients in the highest quartile (Q4) showed a significantly greater prevalence of several cardiovascular risk factors, such as age (Q1: 58.5±11 vs. Q4: 60.3±11 years, P<0.001), serum total cholesterol (Q1: 213.0±46 vs. Q4: 216.4±51 mg/dl, P<0.05), blood glucose (Q1: 106.2±35 vs. Q4: 109.8±39 mg/dl, P<0.005), previous cardiovascular events (Q1: 57.4 vs. Q4: 63.9%, P<0.001), and resistant hypertension (Q1: 26.3 vs. Q4: 34.1%, P<0.001). They also showed higher office (Q1: 143.2±18 vs. Q4: 154.3±19 mmHg, P<0.001) and 24-h ambulatory SBP values (Q1: 134.8±17 vs. Q4: 141.2±18 mmHg, P<0.001). Similar results were obtained when BPV was expressed as SD. Conclusion: Our study provides evidence that greater within-visit BP variabilities are associated with a worse cardiovascular risk profile. This suggests that even this type of BPV may have clinical significance.
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