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Seasonal Variation in Day-by-Day Home Blood Pressure Variability and Effect on Cardiovascular Disease Incidence
Keisuke Narita1, Satoshi Hoshide1, Kazuomi Kario1
1Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
Insights
Day-by-day home blood pressure variability (BPV) is linked to cardiovascular disease (CVD) risk, especially in winter. Winter BPV measurements show a stronger association with future CVD events than other seasons.
Area of Science:
- Cardiology
- Hypertension Research
- Public Health
Background:
- Day-by-day home blood pressure variability (BPV) is a known risk factor for cardiovascular disease (CVD).
- The seasonal influence on the association between home BPV and CVD risk is not well understood.
- This study investigates seasonal variations in home BPV and its impact on CVD risk.
Purpose of the Study:
- To evaluate seasonal differences in day-by-day home blood pressure variability (BPV).
- To determine if the association between home BPV and cardiovascular disease (CVD) risk varies by season.
Main Methods:
- Analysis of data from the J-HOP nationwide prospective observational study.
- Inclusion of 4231 participants, with 91.5% diagnosed with hypertension.
- Measurement of day-by-day home systolic blood pressure variability (SBPV) using SD, coefficient of variation, and average real variability over 14 days.
Main Results:
- Day-by-day home BPV indices were lower in summer compared to winter.
- In winter, higher SD, coefficient of variation, and average real variability of SBP were significantly associated with increased CVD event risk.
- These associations were significant for coronary artery disease, stroke, heart failure, and aortic dissection.
Conclusions:
- Day-by-day home BPV measured during winter demonstrates a stronger association with future cardiovascular disease (CVD) incidence.
- Seasonal variations in home BPV may influence its predictive value for CVD risk.
Background:
Although day-by-day home blood pressure (BP) variability (BPV) has been associated with cardiovascular disease (CVD) risk, it remains unclear whether this association differs from season to season. The present study aimed to assess seasonal variation in day-by-day home BP variability and its association with CVD risk.
Methods:
We analyzed the data from a nationwide, prospective observational study, the J-HOP study (Japan Morning Surge-Home Blood Pressure), in which 14 consecutive days of home BP monitoring were conducted. The values of SD (SDsystolic BP [SBP]), coefficient of variationSBP, and average real variabilitySBP of home SBP were used as indices of day-by-day home BPV.
Results:
Among 4231 participants (mean age, 64.9±10.9 years, 46.7% male, 91.5% hypertensives), all 3 day-by-day home BPV indices were lower in summer than winter after adjusting for confounding factors. In winter, SDSBP, coefficient of variationSBP, and average real variabilitySBP were significantly associated with increased risk of CVD events (coronary artery disease, stroke, heart failure, and aortic dissection; adjusted hazard ratio [95%CI] per 1-SD of SDSBP, 1.26 [1.02-1.54]; coefficient of variationSBP, 1.24 [1.02-1.52]; average real variabilitySBP, 1.44 [1.17-1.77]). These relationships were also observed in the analysis of quartiles of BPV parameters (adjusted hazard ratio [95%CI] compared to the first quartile, fourth quartile of SDSBP 2.26 [1.06-4.85]; coefficient of variationSBP 2.96 [1.43-6.15]; average real variabilitySBP 2.73 [1.25-5.93]). In other seasons, however, there were no significant associations between day-by-day home BPV and CVD event risk.
Conclusions:
Our findings indicate that day-by-day home BPV measured in winter is more strongly associated with future CVD incidence than that measured in other seasons.
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