Baseline blood pressure modifies the role of blood pressure variability in mortality: Results from the ACCORD trial

Abstract

Previous studies indicate that visit-to-visit blood pressure variability (BPv), independent of mean blood pressure level, is associated with adverse cardiovascular outcomes and mortality. [1][2][3] These findings have included cohorts both with and without diabetes. In a recent meta-analysis of patients with type 2 diabetes (T2D), a significant 12% increase in all-cause mortality was linked to systolic BPv. 4 A more recent body of literature suggests that associations between BPv and risk of nonfatal cardiovascular outcomes may be influenced by baseline blood pressure level. For example, those with blood pressure below the study median were more susceptible to risk due to BPv in several clinical trials, 3,5,6 and more recently, we noted that a U-shaped association for BPv by baseline blood pressure levels with cardiovascular disease (CVD) may exist. 7 Whether these more complex risk patterns are also pertinent to mortality is an important, and underexplored, question.

Provisional Decision-Making for Perioperative Blood Pressure Management: A Narrative Review

“…Furthermore, if the first BP was consistent with normotension, the BP reflected the baseline BP. Based on the previous literatures, a widely accepted protocol to determine awake baseline BP is to take BP measurement 3 to 5 times in the ward or visiting clinic after resting 5 to 10 minutes in a quiet and comfortable site, and the average of all readings can be regarded as baseline BP [ 35 , 36 ].…”