Journal ArticleDOI
Visit-to-visit SBP variability and cardiovascular disease in a multiethnic primary care setting: 10-year retrospective cohort study.
TLDR
BPV is associated with an increase in CVD events even in those who have achieved lower mean SBP, and should be prioritize not only control of SBP levels but also BPV to reduce CVD Events further.Abstract:
Objectives: The current study aims to determine the relationship of long-term visit-to-visit variability of SBP to cardiovascular disease (CVD) in a multiethnic primary care setting.
Method: This is a retrospective study of a cohort of 807 hypertensive patients over a period of 10 years. Three-monthly clinic blood pressure readings were used to derive blood pressure variability (BPV), and CVD events were captured from patient records.
Results: Mean age at baseline was 57.2 ± 9.8 years with 63.3% being women. The BPV and mean SBP over 10 years were 14.7 ± 3.5 and 142 ± 8 mmHg, respectively. Prevalence of cardiovascular event was 13%. In multivariate logistic regression analysis, BPV was the predictor of CVD events, whereas the mean SBP was not independently associated with cardiovascular events in this population. Those with lower SBP and lower BPV had fewer cardiovascular events than those with the same low mean SBP but higher BPV (10.5 versus 12.8%). Similarly those with higher mean SBP but lower BPV also had fewer cardiovascular events than those with the same high mean and higher BPV (11.6 versus 16.7%). Other variables like being men, diabetes and Indian compared with Chinese are more likely to be associated with cardiovascular events.
Conclusion: BPV is associated with an increase in CVD events even in those who have achieved lower mean SBP. Thus, we should prioritize not only control of SBP levels but also BPV to reduce CVD events further.read more
Citations
More filters
Journal ArticleDOI
Morning surge in blood pressure and blood pressure variability in Asia: Evidence and statement from the HOPE Asia Network
Guru Prasad Sogunuru,Guru Prasad Sogunuru,Kazuomi Kario,Jinho Shin,Chen Huan Chen,Peera Buranakitjaroen,Yook C. Chia,Romeo Divinagracia,Jennifer Nailes,Sungha Park,Saulat Siddique,Jorge Sison,Arieska Ann Soenarta,Jam Chin Tay,Yuda Turana,Yuqing Zhang,Satoshi Hoshide,Ji-Guang Wang +17 more
TL;DR: Differences in hypertension and related cardiovascular disease rates have been reported between Western and Asian populations, including a higher rate of stroke, higher prevalence of metabolic syndrome, greater salt sensitivity and more common high morning and nocturnal BP readings in Asians.
Journal ArticleDOI
Association Between Blood Pressure Variability, Cardiovascular Disease And Mortality In Type 2 Diabetes: A Systematic Review And Meta‐Analysis
Martina Chiriacò,Konstantinos Pateras,Agostino Virdis,Marietta Charakida,Despoina Kyriakopoulou,Monica Nannipieri,Michele Emdin,Konstantinos Tsioufis,Stefano Taddei,Stefano Masi,Stefano Masi,Georgios Georgiopoulos,Georgios Georgiopoulos +12 more
TL;DR: To investigate the associations of blood pressure variability (BPV), expressed as long‐term and short‐term, and all‐cause mortality, major adverse cardiovascular events (MACEs), extended MACEs, microvascular complications (MiCs) and hypertension‐mediated organ damage (HMOD) in adult patients with type 2 diabetes.
Journal Article
In Patients with Type 2 Diabetes and CV Disease, Empagliflozin Reduces CV and All-Cause Mortality.
TL;DR: In patients with established CV disease and type 2 diabetes, the addition of empagliflozin to standard therapy reduces all-cause mortality and CV mortality.
Journal ArticleDOI
Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia
TL;DR: The minimum number of blood pressure measurements needed to estimate long-term visit-to-visit BPV is determined, suggesting a minimum of six BP measurements is needed for reliably estimating intraindividual BPV for CV outcome prediction.
References
More filters
Journal ArticleDOI
The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report.
Aram V. Chobanian,George L. Bakris,Henry R. Black,William C. Cushman,Lee A. Green,Joseph L. Izzo,Daniel W. Jones,Barry J. Materson,Suzanne Oparil,Jackson T. Wright,Edward J. Roccella +10 more
TL;DR: The most effective therapy prescribed by the most careful clinician will control hypertension only if patients are motivated, and empathy builds trust and is a potent motivator.
Journal ArticleDOI
A New Equation to Estimate Glomerular Filtration Rate
Andrew S. Levey,Lesley A. Stevens,Christopher H. Schmid,Yaping (Lucy) Zhang,Alejandro F. Castro,Harold I. Feldman,John W. Kusek,Paul W. Eggers,Frederick Van Lente,Tom Greene,Josef Coresh +10 more
TL;DR: The CKD-EPI creatinine equation is more accurate than the Modification of Diet in Renal Disease Study equation and could replace it for routine clinical use.
Journal ArticleDOI
Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension.
Peter M. Rothwell,Sally C Howard,Eamon Dolan,Eoin O'Brien,Joanna Dobson,Björn Dahlöf,Peter S. Sever,Neil R Poulter +7 more
TL;DR: Visit-to-visit variability in systolic blood pressure (SBP) and maximum SBP are strong predictors of stroke, independent of mean SBP.
Journal ArticleDOI
Prognostic significance of blood pressure and heart rate variabilities: the Ohasama study.
Masahiro Kikuya,Atsushi Hozawa,Takayoshi Ohokubo,Ichiro Tsuji,Mari Michimata,Mitsunobu Matsubara,Masahiro Ota,Kenichi Nagai,Tsutomu Araki,Hiroshi Satoh,Sadayoshi Ito,Shigeru Hisamichi,Yutaka Imai +12 more
TL;DR: The blood pressure and heart rate variabilities obtained every 30 minutes by ambulatory blood pressure monitoring were independent predictors for cardiovascular mortality in the general population.