Visit-to-Visit Blood Pressure Variability

Mancia, Giuseppe

doi:10.1161/hypertensionaha.116.07139

Cited by 19 publications

(13 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In prior research, BPV has been associated with a higher risk of stroke, coronary artery disease, and chronic kidney disease. [32][33][34] However, the reported effects of BPV on WMH progression are controversial. 35,36 ACCORD MIND offers unique advantages to examine these hypotheses, including a large sample size, an extended follow-up period between study MRIs, and a standardized MRI protocol with semiautomated quantitative volumetric measurement of WMH.…”

Section: Resultsmentioning

confidence: 99%

Blood pressure, glycemic control, and white matter hyperintensity progression in type 2 diabetics

et al. 2019

View full text Add to dashboard Cite

Objective To determine whether higher blood pressure mean (BPM) or hemoglobin A1c is associated with progression of white matter hyperintensity (WMH) on MRI in patients with type 2 diabetes, and whether intensive blood pressure or glycemic control can reduce that progression. Methods We performed a secondary analysis of the Action to Control Cardiovascular Risk in Diabetes Memory in Diabetes (ACCORD MIND) research materials. The primary outcome is change in WMH volume (DWMH) between a baseline and month-40 MRI, and the primary predictor is BPM and A1c between the MRIs. Additional analyses compared DWMH in the intensive vs standard glycemic control randomization arms (n = 502) and intensive vs standard blood pressure control randomization arms (n = 314).

show abstract

Section: Resultsmentioning

confidence: 99%

Blood pressure, glycemic control, and white matter hyperintensity progression in type 2 diabetics

et al. 2019

View full text Add to dashboard Cite

show abstract

“…The association of high BPV with higher morbidity and mortality reported in several patient-populations has been attributed to modifications on the factors influencing regional circulation and blood pressure [10][11][12][13] . In EPHESUS, high BPV was positively associated with older age, renal dysfunction, low systolic blood pressure, and higher use of ACEi/ARBs.…”

Section: Discussionmentioning

confidence: 99%

“…Visit-to-visit office blood pressure variability (BPV) has prognostic implications independent of mean blood pressure (BP) across several populations in the cardiovascular field [1][2][3][4][5][6] . High BPV may be related to one or more of autonomic dysfunction, arteriosclerosis, increased sympathetic tone, arterial stiffness, some blood pressure-lowering agents and treatment nonadherence [7][8][9][10][11][12][13] .…”

Section: Introductionmentioning

confidence: 99%

Visit-to-visit blood pressure variation is associated with outcomes in a U-shaped fashion in patients with myocardial infarction complicated with systolic dysfunction and/or heart failure

Ferreira

Duarte

Pitt

et al. 2018

Journal of Hypertension

View full text Add to dashboard Cite

show abstract

“…The magnitude of this variability can be influenced by factors affecting regional and systemic circulations including arterial stiffness, sympathetic tone, release of vasoactive substances, and baroreceptor sensitivity 1, 2 . Visit-to-visit office blood pressure variability (OBPV) can also be affected by medication non-adherence, class of antihypertensive medication, timing of medication administration, intensity of BP treatment and patient age 3–5 .…”

Section: Introductionmentioning

confidence: 99%

Visit-to-Visit Office Blood Pressure Variability and Cardiovascular Outcomes in SPRINT (Systolic Blood Pressure Intervention Trial)

et al. 2017

View full text Add to dashboard Cite

Studies of visit-to-visit office blood pressure variability (OBPV) as a predictor of cardiovascular events and death in high-risk patients treated to lower BP targets are lacking. We conducted a post hoc analysis of the Systolic Blood Pressure Intervention Trial (SPRINT), a well-characterized cohort of participants randomized to intensive (<120 mm Hg) or standard (<140 mm Hg) systolic BP targets. We defined OBPV as the coefficient of variation of the systolic BP, using measurements taken during the 3-,6-, 9- and 12-month study visits. In our cohort of 7879 participants, older age, female sex, black race, current smoking, chronic kidney disease and coronary disease were independent determinants of higher OBPV. Use of thiazide-type diuretics or dihydropyridine calcium channel blockers was associated with lower OBPV, while angiotensin converting enzyme inhibitors or angiotensin receptor blocker use was associated with higher OBPV. There was no difference in OBPV in participants randomized to standard or intensive treatment groups. We found that OBPV had no significant associations with the composite endpoint of fatal and non-fatal cardiovascular events (N=324 primary endpoints; adjusted hazard ratio [HR] 1.20, 95% confidence interval [CI] 0.85–1.69, highest versus lowest quintile), nor with heart failure or stroke. The highest quintile of OBPV (versus lowest) was associated with all-cause mortality (adjusted HR 1.92, CI 1.22–3.03), although the association of OBPV overall with all-cause mortality was marginal (p=0.07). Our results suggest that clinicians should continue to focus on office BP control rather than on OBPV unless definitive benefits of reducing OBPV are shown in prospective trials.

show abstract

Visit-to-Visit Blood Pressure Variability

Cited by 19 publications

References 13 publications

Blood pressure, glycemic control, and white matter hyperintensity progression in type 2 diabetics

Blood pressure, glycemic control, and white matter hyperintensity progression in type 2 diabetics

Visit-to-visit blood pressure variation is associated with outcomes in a U-shaped fashion in patients with myocardial infarction complicated with systolic dysfunction and/or heart failure

Visit-to-Visit Office Blood Pressure Variability and Cardiovascular Outcomes in SPRINT (Systolic Blood Pressure Intervention Trial)

Contact Info

Product

Resources

About