Response to Letter to the Editor concerning manuscript, “Blood pressure variability predicts adverse events and cardiovascular outcomes in sprint”

Abstract

| 1647LETTER TO THE EDITOR of those in the standard group (target systolic BP 140 mm Hg). Our analysis included no BP readings prior to achievement of target systolic BP. Figure 1 shows the frequency distribution of the number of BP measurements included in our analysis. Overall, the analysis performed by Chang et al excluded 16% of all SPRINT participants and 42% of end points; our analysis excluded only 5% of participants and only 8% of end points. Chang et al also commented that our regression model did not include the number of BP measurement visits as a covariate. We re-ran the regression with that parameter included (Table 1) and obtained similar results.Thirdly, Chang et al observed that we did not include known confounders of BPV in our regression model. We re-ran the regression, including age, sex, race, baseline coronary disease, baseline chronic kidney disease, baseline smoking status, and average systolic BP (in addition to randomized treatment group and measures of BPV in the original model) as covariates (Table 1) and obtained similar results.The fundamental difference between our approach and that of Chang et al is that we focused on diastolic BPV where we did find a clinically relevant result, while they did not investigate the potential effect of diastolic BPV. CO N FLI C T O F I NTE R E S TAll authors have no conflicts of interest to declare. O RCI D Kenechukwu Mezue

Association Between Systolic and Diastolic Blood Pressure Variability and the Risk of End-Stage Renal Disease

“…In the last few decades, interest has been focused on BP variability, and consistent results of the association with BP variability and cardiovascular outcome 20–22 and dementia have been shown. 23 However, the association between BP variability and CKD progression remains only SBP variability and renal outcome.…”