Blood pressure variability within a single visit and all-cause mortality

Area of Science:

• Cardiovascular Medicine
• Clinical Epidemiology
• Biostatistics

Background:

• Within-visit blood pressure (BP) variability impacts measurement precision and hypertension management.
• Limited data exist on the predictive ability of within-visit BP variability for clinical outcomes.
• Understanding BP variability is crucial for accurate risk assessment.

Purpose of the Study:

• To investigate the association between the variability of three repeated office BP measurements and the risk of all-cause mortality.
• To determine if BP variability predicts mortality independently of mean BP levels.
• To identify specific BP variability indices with prognostic value.

Main Methods:

• Analysis of data from the National Health and Nutrition Examination Survey (NHANES).
• Inclusion of 24,969 individuals with complete BP measurements and survival status.
• Utilized multivariable logistic regression to assess prognostic ability of demographic, clinical, and hemodynamic indices.

Main Results:

• The standard deviation of diastolic blood pressure (DBPSD) emerged as a stronger independent predictor of mortality.
• DBPSD showed a significant association with mortality (OR 1.064, 95% CI: 1.011-1.12) after comprehensive adjustments.
• This predictive ability was observed independent of systolic BP, age, sex, BMI, and other cardiovascular risk factors.

Conclusions:

• Within-visit variability of sequential diastolic BP readings can identify high-risk patients more effectively than mean BP levels.
• The prognostic value of within-visit BP variability warrants further investigation.
• Research into methods to enhance the clinical application of BP variability is recommended.