Treating Visit-to-Visit Blood Pressure Variability to Improve Prognosis

Κόλλιας, Αναστάσιος; Stergiou, George S.; Kyriakoulis, Konstantinos G; Bilo, Grzegorz; Parati, Gianfranco

doi:10.1161/hypertensionaha.117.10087

Cited by 39 publications

(33 citation statements)

References 36 publications

(59 reference statements)

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“…The use of ACE inhibitor, beta blocker, and calcium channel blocker were associated with visit-to-visit BP variability, a finding consistent with a previous observational study [6]. Recent clinical trials reported the use of calcium channel blocker was associated with lower visit-to visit BP variability [26, 27]. Our result was not consistent with these recent results.…”

Section: Discussionsupporting

confidence: 73%

Factors associated with intra-individual visit-to-visit variability of blood pressure in four countries: the INTERMAP study

Takashima

Miura

Okayama³

et al. 2018

J Hum Hypertens

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Several studies demonstrated that visit-to-visit variability of blood pressure (BP) predicted future events of total death, stroke and cardiovascular disease. Little is known about factors associated with visit-to-visit BP variability in different countries. We recruited participants aged 40–59 years from four countries (Japan, the People’s Republic of China [PRC], the United Kingdom [UK] and the United States [US]). At each study visit, BP was measured twice by trained observers using random zero sphygmomanometers after five minutes resting. We defined visit-to-visit BP variability as variation independent of mean (VIM) by using average systolic BP of 1st and 2nd measurement across four study visits. Data on 4680 men and women were analyzed. Mean ± standard deviation of VIM values among participants in Japan, the PRC, the UK and the US were 5.44 ± 2.88, 6.85 ± 3.49, 5.65 ± 2.81 and 5.84 ± 3.01, respectively; VIM value in the PRC participants was significantly higher. Sensitivity analyses among participants without antihypertensive treatment or past history of cardiovascular disease yielded similar results. Higher VIM value was associated with older age, female gender, lower pulse rate and urinary sodium excretion and use of antihypertensive agents such as angiotensin converting enzyme inhibitors, beta blockers and calcium channel blockers. The difference of visit-to-visit BP variability between PRC and other countries remained significant after adjustment for possible confounding factors. In this large international study across four countries, visit-to-visit BP variability in the PRC was higher than in the other three countries. Reproducibility and mechanisms of these findings remain to be elucidated.

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Section: Discussionsupporting

confidence: 73%

Factors associated with intra-individual visit-to-visit variability of blood pressure in four countries: the INTERMAP study

Takashima

Miura

Okayama³

et al. 2018

J Hum Hypertens

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“…This class of antihypertensive agents was indeed found to be was more effective in reducing BPV and the related organ damage in experimental animals . Currently, several clinical studies have also consistently supported the potential advantage of these drugs in reducing ambulatory, home, and clinic BPV, but these papers mainly included post hoc analyses of trials, while ad hoc studies are few . Apart from the use of specific drugs, it seems fundamental that iatrogenic increase in BPV, induced for example by short‐acting antihypertensive drugs, should be avoided.…”

Section: Treatment Effects On Bpvmentioning

confidence: 99%

“…In fact, a recent large study on the relationship between BPV and chronic kidney disease (where arterial stiffness is also relevant) showed that with worsening renal function, an increase occurs in systolic, but not ad hoc studies are few. 15,16 Apart from the use of specific drugs, it seems fundamental that iatrogenic increase in BPV, induced for example by short-acting antihypertensive drugs, should be avoided.…”

Section: Clinic Al Rele Van Cementioning

confidence: 99%

Blood pressure variability: clinical relevance and application

Parati

Stergiou

Dolan

et al. 2018

J of Clinical Hypertension

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198

208

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Blood pressure variability is an entity that characterizes the continuous and dynamic fluctuations that occur in blood pressure levels throughout a lifetime. This phenomenon has a complex and yet not fully understood physiological background and can be evaluated over time spans ranging from seconds to years. The present paper provides a short overview of methodological aspects, clinical relevance, and potential therapeutic interventions related to the management of blood pressure variability.

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“…In terms of pharmacotherapy, calcium SAKAMOTO, ET AL channel blockers, 45,46) β-blockers 47) and renin-angiotensinaldosterone system inhibitors 48,49) reportedly increase BRS. A calcium channel blocker, an antihypertensive agent, reportedly decreased BPV, 50,51) therefore, such an agent may act through an as-yet unknown mechanism to improve BRS.…”

Section: Baroreflex Sensitivity and Variability Of Blood Pressurementioning

confidence: 99%

Clinical Implications of Baroreflex Sensitivity in Type 2 Diabetes

Sakamoto

Matsutani

Kayama³

2019

Int. Heart J.

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The evaluation of baroreflex sensitivity (BRS), which maintains systemic circulatory homeostasis, is an established tool to assess cardiovascular autonomic neuropathy in type 2 diabetes mellitus (T2DM). As BRS plays an important function in blood pressure regulation, reduced BRS leads to an increase in blood pressure variability, which further leads to reduced BRS. This sequence of events becomes a vicious cycle. The major risk factors for reduced BRS are T2DM and essential hypertension, but many other risk factors have been reported to influence BRS. In recent years, reports have indicated that glycemic variability (GV), such as short-and longterm GV that are considered important risk factors for macrovascular and microvascular complications, is involved in reductions in BRS independently of blood glucose levels. In this review, we discuss reduced BRS in T2DM, its features, and the potential for its reversal.(Int Heart J 2019; 60: 241-246)

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Treating Visit-to-Visit Blood Pressure Variability to Improve Prognosis

Cited by 39 publications

References 36 publications

Factors associated with intra-individual visit-to-visit variability of blood pressure in four countries: the INTERMAP study

Factors associated with intra-individual visit-to-visit variability of blood pressure in four countries: the INTERMAP study

Blood pressure variability: clinical relevance and application

Clinical Implications of Baroreflex Sensitivity in Type 2 Diabetes

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