Does Blood Pressure Variability Modulate Cardiovascular Risk?

Rothwell, Peter M.

doi:10.1007/s11906-011-0201-3

Cited by 66 publications

(52 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the clinical significance of BP variability in cardiovascular diseases remains controversial. [14][15][16] Determinants and prognostic relevance for cardiovascular outcomes are probably different among short-term (beat-to-beat), short-term (for 24 hours), midterm (day-to-day), and long-term BP variability (visit-to-visit).…”

Section: Day-by-day Bp Variability and Stroke Outcome 1833mentioning

confidence: 99%

Day-by-Day Blood Pressure Variability and Functional Outcome After Acute Ischemic Stroke

Fukuda

Kai

Kamouchi

et al. 2015

Stroke

View full text Add to dashboard Cite

Therefore, BP variability in both the acute and subacute stages Background and Purpose-The relationship between blood pressure (BP) variability and functional outcome in patients with acute ischemic stroke remains unclear. This study aimed to elucidate whether in-hospital day-by-day BP variability is associated with functional outcome after acute ischemic stroke. Methods-Using the Fukuoka Stroke Registry, we included 2566 patients with a first-ever ischemic stroke who had been functionally independent before the onset and were hospitalized within 24 hours. BP was measured daily, and its variability was assessed by SD, coefficients of variance, and variations independent of mean. Poor functional outcome was assessed by modified Rankin Scale scores ≥3 at 3 months. Results-After adjustment for multiple confounding factors including age, sex, risk factors, stroke features, baseline severity, thrombolytic therapy, antihypertensive agents, and mean BP, day-by-day BP variability during the subacute stage (4-10 days after onset) was independently associated with a poor functional outcome (multivariable-adjusted odds ratios [95% confidence interval] in the top versus bottom quartile of systolic BP variability, 1.51 [1.09-2.08] for SD; 1.63 [1.20-2.22] for coefficients of variance; 1.64 [1.21-2.24] for variations independent of mean). Similar trends were also observed for diastolic BP variability. These trends were unchanged in patients who were not treated with antihypertensive drugs. In contrast, no association was found between indices of BP variability during the acute stage and functional outcome after adjusting for potential confounders. Conclusions-These data suggest that intraindividual day-by-day BP variability during the subacute stage is associated with the 3-month functional outcome after acute ischemic stroke. Fukuda et al Day-by-Day BP Variability and Stroke Outcome 1833may have clinical significance in functional outcome after acute stroke. An interval of BP fluctuations used in the previous studies ranged from beat-to-beat, hour-to-hour to day-to-night. However, the clinical significance of BP variability in cardiovascular diseases remains controversial. [14][15][16] Determinants and prognostic relevance for cardiovascular outcomes are probably different among short-term (beat-to-beat), short-term (for 24 hours), midterm (day-to-day), and long-term BP variability (visit-to-visit).15 BP fluctuations with longer intervals, including midterm and long-term BP variability, are of increasing clinical interest as predictors of end-organ damage, 17 cardiovascular events, 18-21 and mortality. 22 A recent study showed a possible association of visit-to-visit BP variability with longterm mortality after lacunar infarct. 23 However, the association between BP variability with a long interval and functional outcome after ischemic stroke is still unknown.In the present study, we calculated indices of day-by-day BP variability until the subacute stage and investigated their association with short-term clinical outcomes ...

show abstract

Section: Day-by-day Bp Variability and Stroke Outcome 1833mentioning

confidence: 99%

Day-by-Day Blood Pressure Variability and Functional Outcome After Acute Ischemic Stroke

Fukuda

Kai

Kamouchi

et al. 2015

Stroke

View full text Add to dashboard Cite

show abstract

“…In addition, BPV also seems to contribute in the development of microvascular complications in type 1 and type 2 diabetes and with the progression of renal failure and mortality in patients at end-stage chronic kidney disease. Therefore, increased BPV is nowadays considered a new risk factor of cardiovascular disease and a possible new target for antihypertensive therapy [6,64,[93][94][95][96].…”

Section: Perspectivesmentioning

confidence: 99%

Blood Pressure Variability: Prognostic Value and Therapeutic Implications

Höcht

2013

ISRN Hypertension

View full text Add to dashboard Cite

Blood pressure variability (BPV) is considered nowadays a novel risk factor for cardiovascular disease. Early findings in sinoaortic denervated rats have clearly shown that enhanced fluctuation of blood pressure induced left ventricular hypertrophy, vascular stiffness, and renal lesion. A large number of clinical trials confirm that short-term and long-term blood pressure variability independently contributes to target organ damage, cardiovascular events, and mortality not only in hypertensive patients but also in subjects with diabetes mellitus and chronic kidney disease. Therefore, amelioration of BPV has been suggested as an additional target of the treatment of cardiovascular diseases. Preliminary evidence obtained from meta-analysis and controlled clinical trials has shown that antihypertensive classes differ in their ability to control excessive BP fluctuations with an impact in the prevention of cardiovascular events. Calcium channel blockers seem to be more effective than other blood pressure lowering drugs for the reduction of short-term and long-term BPV. In order to increase actual knowledge regarding the prognostic value and therapeutic significance of BPV in cardiovascular disease, there is a need for additional clinical studies specifically designed for the study of the relevance of short-term and long-term BPV control by antihypertensive drugs.

show abstract

“…However, ambulatory blood pressure measurement (ABPM) provides serial BP measurements and information on different subsets of BP, like day-and night time BP, resulting in a high reproducibility and the possibility to evaluate circadian distribution of BP levels, respectively [11,12]. It could be shown that by the use of ABPM, treatment evaluations in clinical trials as well as in clinical practice become more efficient and reliable [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Effects of Renal Denervation on Blood Pressure Burden in Patients with Resistant Arterial Hypertension

Àlex¹,

Nahler²,

Lambert³

et al. 2016

Arch Med

View full text Add to dashboard Cite

Background: Catheter based ablation of nerves in the adventitia of renal arteries (renal denervation) by the use of radiofrequency energy can reduce blood pressure levels in patients with resistant arterial hypertension. Blood pressure burden (BPB), defined by the proportion of elevated blood pressure values during day and night time is associated with increased cardiovascular morbidity and mortality. We investigated the long-term effects of renal denervation on blood pressure burden out to 12 months.

show abstract

Does Blood Pressure Variability Modulate Cardiovascular Risk?

Cited by 66 publications

References 98 publications

Day-by-Day Blood Pressure Variability and Functional Outcome After Acute Ischemic Stroke

Day-by-Day Blood Pressure Variability and Functional Outcome After Acute Ischemic Stroke

Blood Pressure Variability: Prognostic Value and Therapeutic Implications

Long-Term Effects of Renal Denervation on Blood Pressure Burden in Patients with Resistant Arterial Hypertension

Contact Info

Product

Resources

About