Within-Visit Blood Pressure Variability and All-Cause and Stroke Mortality: Thai Epidemiologic Stroke Study

Area of Science:

• Cardiovascular Epidemiology
• Clinical Hypertension Research
• Public Health

Background:

• Within-visit blood pressure variability (BPV) association with mortality is not well-established.
• Previous studies have yielded conflicting results regarding BPV's prognostic significance.

Purpose of the Study:

• To investigate the association between within-visit BPV and all-cause and stroke mortality.
• To clarify the prognostic value of blood pressure variability in a general population cohort.

Main Methods:

• Prospective cohort study of 19,614 participants (aged 45-80) from the Thai Epidemiologic Stroke Study.
• Within-visit BPV measured as maximum absolute difference (MAD) in systolic (SBP) and diastolic (DBP) blood pressure from three sequential readings.
• Cox regression analysis used to assess associations with mortality over a median follow-up of 11.1 years.

Main Results:

• Unadjusted analyses showed high within-visit SBP and DBP variability associated with increased all-cause and stroke mortality.
• These associations lost statistical significance after adjustment for confounders like age and sex.
• Sensitivity analysis yielded inconsistent results, suggesting limited prognostic value.

Conclusions:

• Within-visit systolic and diastolic blood pressure variability lack prognostic significance for stroke and all-cause mortality in the general population.
• The findings suggest that mean blood pressure is a more critical predictor than short-term variability.