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Within-visit variability of blood pressure and all-cause and cardiovascular mortality among US adults

Paul Muntner1, Emily B Levitan, Kristi Reynolds

  • 1Department of Epidemiology, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294, USA. pmuntner@uab.edu

Journal of Clinical Hypertension (Greenwich, Conn.)
|March 1, 2012
PubMed

Insights

Within-visit blood pressure variability, specifically systolic blood pressure (SBP) standard deviation, did not significantly predict all-cause or cardiovascular mortality in a large US health survey. Further analysis confirmed no association between SBP variability and mortality risk.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Epidemiology

Background:

  • Blood pressure variability is an emerging cardiovascular risk factor.
  • Within-visit variability, measured by standard deviation of readings during a single encounter, has not been extensively studied in relation to mortality.

Purpose of the Study:

  • To investigate the association between within-visit variability of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and all-cause and cardiovascular disease (CVD) mortality.
  • To determine if SBP or DBP variability predicts long-term mortality risk.

Main Methods:

  • Analysis of data from the Third National Health and Nutrition Examination Survey (NHANES III) with 15,317 participants.
  • Three SBP and DBP measurements were taken per participant during one visit.
  • Within-visit variability was calculated as the standard deviation of these measurements.
  • Mortality data (all-cause and CVD) were tracked over a 14-year follow-up period.

Main Results:

  • After adjusting for age, sex, and race-ethnicity, higher quintiles of within-visit SBP standard deviation showed no statistically significant association with increased all-cause mortality (P=.136) or CVD mortality (P=.566).
  • Further adjustments and continuous variable modeling of SBP standard deviation also revealed no significant link to mortality.
  • Within-visit standard deviation of DBP was not associated with any mortality outcome.

Conclusions:

  • Within-visit variability of SBP, as measured by standard deviation, does not appear to be a significant independent predictor of all-cause or CVD mortality in the general population.
  • These findings suggest that single-visit blood pressure variability may not be a critical factor for long-term mortality risk assessment.

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