Day‐by‐day blood pressure variability in hospitalized patients with COVID‐19

Li, Fei-Ka; An, De‐Wei; Guo, Qian‐Hui; Zhang, Yi-Qing; Qian, Jia-Ye; Hu, Weiguo; Li, Yan; Wang, Ji‐Guang

doi:10.1111/jch.14338

Cited by 11 publications

(13 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… 4 , 5 , 20 , 21 After we adjusted for these confounders, in this study, the variability of SBP, but not DBP, could consistently predict adverse outcomes among COVID‐19 patients with hypertension. Although Li eand coworkers 31 , 32 conducted similar studies, this study included larger sample size and excluded cases without sufficient BP readings to reduce its confounding impact. Our data implied that stable level of blood pressure has better prognosis than fluctuating level in COVID‐19 patients with hypertension.…”

Section: Discussionmentioning

confidence: 99%

Prognostic significance of day‐by‐day in‐hospital blood pressure variability in COVID‐19 patients with hypertension

Liu

Yang

et al. 2022

J of Clinical Hypertension

View full text Add to dashboard Cite

Hypertension is the most common comorbidity in patients with coronavirus disease 2019 (COVID‐19) and increases in‐hospital mortality. Day‐by‐day blood pressure (BP) variability (BPV) is associated with clinical outcomes in hypertensive patients. However, little information is available on the association of BPV with the outcomes of COVID‐19 patients with hypertension. This study aimed to demonstrate whether day‐by‐day in‐hospital BPV had prognostic significance in these patients. The authors included 702 COVID‐19 patients with hypertension from Huoshenshan Hospital (Wuhan, China), who underwent valid in‐hospital BP measurements on at least seven consecutive days. Day‐by‐day BPV was assessed by standard deviation (SD), coefficient of variation (CV), and variation independent of mean (VIM). Overall, patients with severe COVID‐19 and non‐survivors had higher BPV than moderate cases and survivors, respectively. Additionally, higher BPV was correlated with greater age and higher levels of C‐reactive protein, procalcitonin, high‐sensitive cardiac troponin I, and B‐type natriuretic peptide. In multivariable Cox regression, SD of systolic BP (SBP) was predictive of mortality [hazard ratio (HR) 1.17, 95% confidence interval (CI) 1.05–1.30] as well as acute respiratory distress syndrome (ARDS) (HR 1.09, 95% CI 1.01–1.16). Similar trends were observed for CV and VIM of SBP, but not indices of diastolic BP variability. The authors demonstrated that day‐by‐day in‐hospital SBP variability can independently predict mortality and ARDS in COVID‐19 patients with hypertension. And high BPV might be correlated with severe inflammation and myocardial injury. Further studies are needed to clarify whether early reduction of BPV will improve the prognosis of these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Prognostic significance of day‐by‐day in‐hospital blood pressure variability in COVID‐19 patients with hypertension

Liu

Yang

et al. 2022

J of Clinical Hypertension

View full text Add to dashboard Cite

show abstract

“…In patients with acute intracerebral haemorrhage, high systolic BPV was predictive of poor outcome 82 . Furthermore, critically ill patients with COVID-19 who required transfer to other hospitals for further treatment, were admitted to the intensive care unit or died had greater systolic and diastolic BPV than patients with severe COVID-19 who recovered and were discharged from hospital (despite similar use of antihypertensive medication and similar mean BP levels) 83 . Furthermore, even in patients without hypertension, BPV has been associated with glaucomatous optic neuropathy, most probably via hypoperfusion of the optic nerve 84 .…”

Section: Clinical Relevance Of Bpvmentioning

confidence: 99%

Blood pressure and its variability: classic and novel measurement techniques

2022

View full text Add to dashboard Cite

Current hypertension guidelines recommend using the average values of several blood pressure (BP) readings obtained both in and out of the office for the diagnosis and management of hypertension. In-office BP measurement using an upper-arm cuff constitutes the evidence-based reference method for current BP classification and treatment targets. However, out-of-office BP evaluation using 24 h ambulatory or home BP monitoring is recommended by all major medical associations for obtaining further insights into the BP profile of an individual and how it relates to their daily activities. Importantly, the highly variable nature of office and out-of-office BP readings has been widely acknowledged, including the association of BP variability with cardiovascular outcomes. However, to date, the implications of BP variability on cardiovascular outcomes have largely been ignored, with limited application in clinical practice. Novel cuffless wearable technologies might provide a detailed assessment of the 24 h BP profile and behaviour over weeks or months. These devices offer many advantages for researchers and patients compared with traditional BP monitors, but their accuracy and utility remain uncertain. In this Review, we outline and compare conventional and novel methods and techniques for assessing average BP levels and BP variability, and reflect on the utility and potential of these methods for improving the treatment and management of patients with hypertension.

show abstract

“…This condition can be the result of endothelial damage and cytokine storm induced over time by the SARS-COV-2 infection [4] , [10] , [30] . However, the alteration of several other microcirculatory parameters such as: vascular densities, heterogeneity index, functional capillary density, and microvascular flow index, in addition to red blood cells velocity, blood pressure variability and PPG dropout [8] , [31] , [32] , [33] , were associated with COVID-19 disease. A number of studies evaluated the usefulness of PPG signal analysis in the treatment of COVID-19 patients treated in ICU units.…”

Section: Discussionmentioning

confidence: 98%