Blood pressure and heart period variability ratios derived from 24-h ambulatory measurements are predictors of all-cause mortality

Gavish, Benjamin; Bursztyn, Michael

doi:10.1097/hjh.0000000000000459

Cited by 15 publications

(17 citation statements)

References 23 publications

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“…Two recent studies by Melillo and colleagues in 200 hypertensive patients showed that depressed HR variability is associated with higher risk of progression to end‐stage renal disease, suggesting that autonomic dysfunction may lead to kidney damage. Moreover, a large‐scale study in 1246 hypertensive patients showed that the 24‐hour BP‐to‐HR variability ratio is a powerful independent predictor of all‐cause mortality, especially for elderly hypertensive patients with slow HR . The authors suggest this ratio as an integrative index of cardiovascular function and a marker for cardiovascular dysregulation during low diastolic BP states, with potential use in clinical practice …”

Section: Discussionmentioning

confidence: 99%

“…The variability of BP and HR in most studies has been evaluated with the standard deviation of the measurements performed . However, standard deviation is typically dependent on the mean value of the measured variable.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, a large-scale study in 1246 hypertensive patients showed that the 24-hour BP-to-HR variability ratio is a powerful independent predictor of all-cause mortality, especially for elderly hypertensive patients with slow HR. 20 The authors suggest this ratio as an integrative index of cardiovascular function and a marker for cardiovascular dysregulation during low diastolic BP states, with potential use in clinical practice. 20 Regarding the effect of smoking on kidney function, data from the prospective Multiple Risk Factor Intervention Trial in 332,544 men indicate that smoking increases the risk of renal failure in the general male population.…”

Section: Discussionmentioning

confidence: 99%

“…20 The authors suggest this ratio as an integrative index of cardiovascular function and a marker for cardiovascular dysregulation during low diastolic BP states, with potential use in clinical practice. 20 Regarding the effect of smoking on kidney function, data from the prospective Multiple Risk Factor Intervention Trial in 332,544 men indicate that smoking increases the risk of renal failure in the general male population. A dose-dependent increase of the relative risk of end-stage renal failure was found in smokers as compared with nonsmokers (up to 1.69 for heavy smokers).…”

Section: Discussionmentioning

confidence: 99%

“…[23][24][25] The variability of BP and HR in most studies has been evaluated with the standard deviation of the measurements performed. [5][6][7]20,26 However, standard deviation is typically dependent on the mean value of the measured variable. In the present study, the Cv of BP and HR was used instead, as reported in the "Methods" section, which is a more reliable marker of variability as it is indexed for the mean value.…”

Section: Discussionmentioning

confidence: 99%

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Correlation of 24‐Hour Blood Pressure and Heart Rate Variability to Renal Function Parameters in Hypertensive Patients. The Effect of Smoking

Liakos

Karpanou

Markou

et al. 2015

J of Clinical Hypertension

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Intrarenal hemodynamics depend on blood pressure (BP), heart rate (HR), and smoking. Although BP levels have been associated with kidney function, the effect of HR levels, BP, and HR variability on renal function are less well clarified. This cross-sectional study sought to determine the association of 24-hour BP and HR variability with kidney function in hypertensive patients, stratified by smoking. The study comprised 9600 nondiabetic, never-treated hypertensive individuals without evident renal impairment examined from 1985 to 2014 (aged 53.3AE13.4 years, 55.3% males). The 24-hour systolic BP (SBP) and HR variability were estimated via their coefficient of variation (C V =standard deviation9100/ mean value) derived from ambulatory recording. The C V SBPto-C V HR ratio (C V R) was used as a marker of the interplay between 24-hour SBP and HR variability. Renal function was estimated via 24-hour urine creatinine clearance (CrCl), estimated glomerular filtration rate (eGFR), albumin-to-creatinine ratio (ACR), and 24-hour urine a 1 -microglobulin. After adjustment for age, sex, and smoking, C V SBP was found to be weakly correlated to eGFR (r=À0.017, P=.1) and somewhat more strongly to CrCl, ACR, and a 1 -microglobulin (r=À0.032, 0.072, and 0.065; P=.002, <.001 and <.001, respectively). C V HR was much better related to renal function, with stronger adjusted correlations to CrCl, eGFR, ACR, and a 1 -microglobulin (r=0.185, 0.134, À0.306, À0.247; all P<.001, respectively). C V R also showed equally good adjusted correlations (r=À0.175, À0.125, 0.336, 0.262; all P<.001, respectively). Most adjusted correlations for C V HR and C V R were even better in smokers (r=0.213, 0.158, À0.332, À0.272 and À0.183, À0.118, 0.351, 0.275, respectively; all P<.001). C V HR and C V R emerge as better related to kidney function than C V SBP, especially in smokers. The correlation of C V HR and C V SBP to renal function is inverse to each other. ACR and a 1 -microglobulin are better related to variability indices than CrCl and eGFR. However, causal relations cannot be proved. J Clin Hypertens (Greenwich). 2015;17:938-943. ª 2015 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Correlation of 24‐Hour Blood Pressure and Heart Rate Variability to Renal Function Parameters in Hypertensive Patients. The Effect of Smoking

Liakos

Karpanou

Markou

et al. 2015

J of Clinical Hypertension

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Prognostic Value of Ambulatory Blood Pressure Monitoring

Angeli

Verdecchia²

2016

Blood Pressure Monitoring in Cardiovascular Medicine and Therapeutics

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Elevated blood pressure variability is associated with an increased risk of negative health outcomes in adults aged 65 and above—a systematic review and meta-analysis

Saren,

Debain,

Loosveldt

et al. 2024

Age and Ageing

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Background The clinical relevance of blood pressure variability (BPV) is still unknown, despite increasing evidence associating BPV to negative health outcomes (NHOs). There is currently no gold standard to define high BPV and normal reference values for BPV are lacking. Aim The primary aim was to examine whether high BPV can predict NHO in adults aged ≥65. The predictive value of BPV was compared to mean BP (mBP) when both parameters were available. Methods PubMed and Web of Science were systematically screened; 49 articles (12 retrospective, 18 prospective and 19 cross-sectional studies) were included and evaluated for methodological quality. Meta-analyses were conducted to examine the association of BPV (and mBP when available) with NHO. Results Systolic BPV and systolic mBP seem to indicate at least comparable odds for cardiovascular disease (BPV: odds ratio (OR) = 1.33 (95% CI: 1.19–1.48, P < .00001) vs mBP: OR = 1.06 (95% CI: 1.03–1.09, P = .0002)) and cerebral deterioration (BPV: OR = 1.28 (95% CI: 1.17–1.41, P < .00001) vs mBP: OR = 1.06 (95% CI: 1.04–1.09, P < .00001)). Increased diastolic BPV was associated with higher odds of cerebral deterioration (OR = 1.18 (95% CI: 1.04–1.35), P = .01). Conclusion High systolic BPV and high systolic mBP are associated with 33% and 6% higher odds of cardiovascular disease in adults aged ≥65, respectively. High BPV is also related to an 18%–28% and 11% increased odds of cerebral deterioration and poor stroke recovery. An overview of cut-off values is provided for the most often reported BPV parameters in literature, which can be used as a guideline to identify elevated BPV in clinical practice.

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Blood pressure and heart period variability ratios derived from 24-h ambulatory measurements are predictors of all-cause mortality

Cited by 15 publications

References 23 publications

Correlation of 24‐Hour Blood Pressure and Heart Rate Variability to Renal Function Parameters in Hypertensive Patients. The Effect of Smoking

Correlation of 24‐Hour Blood Pressure and Heart Rate Variability to Renal Function Parameters in Hypertensive Patients. The Effect of Smoking

Prognostic Value of Ambulatory Blood Pressure Monitoring

Elevated blood pressure variability is associated with an increased risk of negative health outcomes in adults aged 65 and above—a systematic review and meta-analysis

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