A Re-Defined Blood Pressure Variability Measure and its Association with Mortality in Elderly Primary Care Patients RR
Visit-to-visit blood pressure variability has received considerable attention recently. The objective of our study is to define a variability measure that is independent of change over time and determine the association between longitudinal summary measures of blood pressure measurements and mortali...
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| Published in: | Hypertension (Dallas, Tex. 1979) Tex. 1979), 2014-05, Vol.64 (1), p.45-52 |
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| Main Authors: | , , , , , , , |
| Format: | Article |
| Language: | eng |
| Online Access: | Get full text |
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| Summary: | Visit-to-visit blood pressure variability has received considerable attention recently. The objective of our study is to define a variability measure that is independent of change over time and determine the association between longitudinal summary measures of blood pressure measurements and mortality risk. Data for the study came from a prospective cohort of 2,906 adults, age 60 or older, in an urban primary care system with up to fifteen years follow-up. Dates of death for deceased participants were retrieved from the National Death Index. Systolic and diastolic blood pressure measurements from outpatient clinic visits were extracted from the Regenstrief Medical Record System. For each patient, the intercept, regression slope, and root mean square error for visit-to-visit variability were derived using linear regression models and used as independent variables in Cox's proportional hazards models for both all-cause mortality and mortality due to coronary heart disease or stroke. Rate of change was associated with mortality risk in a U-shaped relationship and that participants with little or no change in blood pressure had the lowest mortality risk. Blood pressure variability was not an independent predictor of mortality risk. By separating change over time from visit-to-visit variability in studies with relatively long follow-up, we demonstrated in this elderly primary care patient population that blood pressure changes over time, not variability, were associated with greater mortality risk. Future research is needed to confirm our findings in other populations. |
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| ISSN: | 0194-911X 1524-4563 |