Home blood pressure variability as cardiovascular risk factor in the population of Ohasama

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Date
2013Author
Asayama, Kei
Kikuya, Masahiro
Schutte, Rudolph
Thijs, Lutgarde
Hosaka, Miki
Metadata
Show full item recordAbstract
Blood pressure variability based on office measurement predicts outcome in selected patients. We explored
whether novel indices of blood pressure variability derived from the self-measured home blood pressure predicted
outcome in a general population. We monitored mortality and stroke in 2421 Ohasama residents (Iwate Prefecture,
Japan). At enrollment (1988–1995), participants (mean age, 58.6 years; 60.9% women; 27.1% treated) measured
their blood pressure at home, using an oscillometric device. In multivariable-adjusted Cox models, we assessed the
independent predictive value of the within-subject mean systolic blood pressure (SBP) and corresponding variability
as estimated by variability independent of the mean, difference between maximum and minimum blood pressure, and
average real variability. Over 12.0 years (median), 412 participants died, 139 of cardiovascular causes, and 223 had a
stroke. In models including morning SBP, variability independent of the mean and average real variability (median, 26
readings) predicted total and cardiovascular mortality in all of the participants (P≤0.044); variability independent of the
mean predicted cardiovascular mortality in treated (P=0.014) but not in untreated (P=0.23) participants; and morning
maximum and minimum blood pressure did not predict any end point (P≥0.085). In models already including evening
SBP, only variability independent of the mean predicted cardiovascular mortality in all and in untreated participants
(P≤0.046). The R2 statistics, a measure for the incremental risk explained by adding blood pressure variability to models
already including SBP and covariables, ranged from <0.01% to 0.88%. In a general population, new indices of blood
pressure variability derived from home blood pressure did not incrementally predict outcome over and beyond mean
SBP.
URI
http://hdl.handle.net/10394/13900https://pubmed.ncbi.nlm.nih.gov/23172933/
https://www.ahajournals.org/doi/10.1161/hypertensionaha.111.00138
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.111.00138
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- Faculty of Health Sciences [2376]