Association Between Visit-to-Visit Blood Pressure Variability in Early Adulthood and Myocardial Structure and Function in Later Life

Nwabuo, Chike C.; Yano, Yuichiro; Moreira, Henrique T.; Appiah, Duke; Vasconcellos, Henrique Doria De; Aghaji, Queen N.; Viera, Anthony J.; Rana, Jamal S.; Shah, Ravi; Murthy, Venkatesh L.; Allen, Norrina B.; Schreiner, Pamela J.; Lloyd‐Jones, Donald M.; Lima, João A.C.

doi:10.1001/jamacardio.2020.0799

Cited by 43 publications

(36 citation statements)

References 42 publications

(79 reference statements)

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“…Prior studies document an association of higher BP variability with CVD, 7 , 8 , 9 stroke, 5 , 6 , 7 left ventricular remodeling, 36 and death. 21 , 28 , 37 , 38 , 39 , 40 , 41 However, most of these studies have focused on relatively short-term outcomes, populations without a prior history of CAD, and relatively younger populations.…”

Section: Discussionmentioning

confidence: 99%

Association of 1-Year Blood Pressure Variability With Long-term Mortality Among Adults With Coronary Artery Disease

et al. 2021

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Key Points Question Is short-term blood pressure variability from one physician office visit to the next (hereafter referred to as visit-to-visit blood pressure variability) associated with increased long-term mortality risk? Findings In this cohort study, 16 688 patients with hypertension who were 50 years of age or older with coronary artery disease were followed up for a mean of 10.9 years. When comparing quintiles of systolic blood pressure variability measures, higher quintiles were associated with long-term mortality even after adjusting for baseline demographic characteristics, mean blood pressure, and comorbidities; the signal was stronger in women compared with men. Meaning These findings support efforts to identify and minimize visit-to-visit blood pressure variability to potentially reduce excess mortality later in life.

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Section: Discussionmentioning

confidence: 99%

Association of 1-Year Blood Pressure Variability With Long-term Mortality Among Adults With Coronary Artery Disease

et al. 2021

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“…For example, VVV was found to be associated with markers of cardiac, vascular, and cerebral diseases as well as albuminuria [ 8 ]. Furthermore, VVV has been related with central sympathetic overactivity, variations in renin–angiotensin–aldosterone system stimulation, adverse alterations in cardiac structure or function (i.e., left ventricular dysfunction, atrial fibrillation), as well as vascular target organ damage (i.e., carotid atherosclerosis and stiffness) in adults [ 12 , 33 ] and the elderly [ 34 ]. In pediatrics with renal disease, increased VVV was tied with reduced eGFR [ 32 ].…”

Section: Discussionmentioning

confidence: 99%

“…Last but not least, BP variability may be independently involved in the progression and severity of cardiac, cerebral and renal target-organ damage. For example, greater BPV appears to increase the risk of adverse alterations in cardiac structure in both adults and pediatrics independent of mean BP levels [ 12 , 16 ]. However, such information is not available for the current study, preventing us to effectively detect the independent prognostic value of VVV.…”

Section: Discussionmentioning

confidence: 99%

“…In adults, ample evidence indicated that higher VVV was associated with the development, progression and severity of vascular, cardiac and renal target-organ damage, and with an increased risk of cardiovascular events and cardiovascular and all-cause mortality, independent of average BP values [ 10 – 12 ]. In addition, higher VVV and impaired cognitive function was observed in the elderly [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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School-based surveillance on visit-to-visit blood pressure variability and high blood pressure in children and adolescents

Wang

Shen²,

Liu

et al. 2021

BMC Cardiovasc Disord

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Background The predictive importance of visit-to-visit blood pressure variability (VVV) for high blood pressure (HBP) in a pediatric population has been largely unsettled. We aimed to evaluate it based on Health Promotion Program for Children and Adolescents (HPPCA), a school-based surveillance conducted from 2012 to 2018 in Suzhou, China. Methods A total of 330,618 participants had BP measurement in 2018 and ≥ 3 BP records during 2012–2017, were recruited from HPPCA. Absolute BP values (in mmHg) were converted into age-, sex- and height- normalized z-scores. VVV was expressed as standard deviation (SD), coefficient of variation (CV) or average real variability (ARV) of BP z-scores during 2012–2017. Logistic regression models were used to assess the associations between VVV and HBP in 2018. Results In 2018, 42,554 (12.87%) subjects were defined as HBP. VVV, except for SBP-CV and DBP-CV, was significantly higher in the HBP group than normotensives group. After adjusting for covariates including mean BP values from 2012 to 2017, SBP-SD, SBP-ARV, DBP-SD and DBP-ARV, increased the risk of HBP by 5.70 [95% confidence interval (95% CI) 5.54–5.87], 4.10 (95% CI 4.01–4.20), 4.70 (95% CI 4.50–4.90) and 3.39 (95% CI 3.28–3.50) times, respectively. Notably, SBP-SD significantly improved risk discrimination of HBP based on other risk variables (c-statistics, net reclassification index and integrated discrimination improvement significantly increased). Conclusions Higher SD or ARV of BP, was independently related with higher probability of HBP in Chinese pediatric population. SBP-SD could be potentially helpful for detecting HBP. Future researches investigating the predictive value of VVV are warrant.

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“…The CV was calculated as (SD/mean) × 100% [24]. The ARV calculated as the average absolute difference between successive measurements [25]. The VIM was calculated as 100 × SD/mean beta , where beta is the regression coefficient based on a natural logarithm of SD on the natural logarithm of the mean [26].…”

Section: Measurement Of Sua Change and Variabilitymentioning

confidence: 99%

Visit-to-visit variability of serum uric acid measurements and the risk of all-cause mortality in the general population

et al. 2021

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Background Evidence on longitudinal variability of serum uric acid (SUA) and risk of all-cause mortality in the general population is limited, as many prior studies focused on a single measurement of SUA. Methods A total of 53,956 participants in the Kailuan study who underwent three health examinations during 2006 to 2010 were enrolled. Variability of SUA was measured using the coefficient of variation (primary index), standard deviation, average real variability, and variability independent of the mean. Cox proportional hazard regressions were used to calculate the hazard ratio (HR) and 95% confidence interval (CI) for the association of variability of SUA with subsequent risk of all-cause mortality, considering its magnitude and the direction and across different baseline SUA categories. Results Over a median follow-up of 7.04 years, 2728 participants died. The highest variability of SUA was associated with an increased risk of all-cause mortality, the HR was 1.33 (95% CI, 1.20–1.49) compared with the lowest variability. In this group, both a large fall (HR, 1.28; 95% CI, 1.14–1.44) and rise (HR, 1.18; 95% 1.05–1.32) in SUA were related to risk of all-cause mortality. These associations were similar across different baseline SUA categories. Consistent results were observed in alternative measures of SUA variability. Moreover, individuals with higher variability in SUA were more related to common risk factors than those with stable SUA. Conclusions Higher variability in SUA was independently associated with the risk of all-cause mortality irrespective of baseline SUA and direction of variability in the general population.

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Association Between Visit-to-Visit Blood Pressure Variability in Early Adulthood and Myocardial Structure and Function in Later Life

Cited by 43 publications

References 42 publications

Association of 1-Year Blood Pressure Variability With Long-term Mortality Among Adults With Coronary Artery Disease

Association of 1-Year Blood Pressure Variability With Long-term Mortality Among Adults With Coronary Artery Disease

School-based surveillance on visit-to-visit blood pressure variability and high blood pressure in children and adolescents

Visit-to-visit variability of serum uric acid measurements and the risk of all-cause mortality in the general population

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