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Published on: May 3, 2018
Significance of blood pressure variability in normotensive individuals as a risk factor of developing hypertension
Hiroyuki Takase1, Tomonori Sugiura2, Sumiyo Yamashita3
1Department of Internal Medicine, Enshu Hospital, Hamamatsu, Japan.
Insights
Increased year-to-year blood pressure variability, particularly the highest systolic blood pressure, predicts hypertension risk in the Japanese general population. This finding highlights variability as a key indicator for hypertension development.
Area of Science:
- Cardiology
- Hypertension Research
- Preventive Medicine
Background:
- Visit-to-visit blood pressure variability is a recognized predictor of cardiovascular events and hypertensive target organ damage.
- Understanding year-to-year blood pressure variability's role in hypertension risk is crucial for public health.
Purpose of the Study:
- To investigate if year-to-year blood pressure variability predicts hypertension risk in the Japanese general population.
- To identify specific metrics of blood pressure variability that are significant predictors of future hypertension.
Main Methods:
- Analysis of 2806 normotensive individuals over five years of physical check-ups (2008-2013).
- Calculation of average, standard deviation, coefficient of variation, average real variability, and highest systolic blood pressure (SBP) from consecutive visits.
- Six-year follow-up to monitor the development of hypertension (SBP ≥140/90 mmHg or antihypertensive medication use).
Main Results:
- Hypertension developed in 13.9% of participants during follow-up.
- Increased standard deviation and average real variability of SBP correlated with higher hypertension incidence.
- Average SBP, standard deviation, average real variability, and highest SBP were significant predictors of hypertension development, unlike the coefficient of variation.
Conclusions:
- Elevated year-to-year blood pressure variability is a significant predictor of hypertension risk in normotensive individuals.
- The highest recorded systolic blood pressure in preceding years may also serve as a strong predictor for future hypertension development.
Purpose:
Visit-to-visit blood pressure variability is a strong predictor of the incidence of cardiovascular events and target organ damage due to hypertension. The present study investigated whether year-to-year blood pressure variability predicts the risk of hypertension in the Japanese general population.
Materials And Methods:
This study analysed 2806 normotensive individuals who participated in our physical check-up program for five years in a row from 2008 to 2013. The average, standard deviation, coefficient of variation, average real variability, and highest value of systolic blood pressure in the five consecutive visits were determined and used as baseline data. The participants were followed up for the next 6 years with the development of 'high blood pressure', an average blood pressure level of ≥140/90 mmHg or the use of antihypertensive medications, as the endpoint.
Result:
During follow-up, 'high blood pressure' developed in 389 participants (13.9%, 29.5 per 1 000 person-years). The incidence increased across the quartiles of standard deviation and average real variability, while the average and highest systolic blood pressure had the most prominent impact on the development of 'high blood pressure'. Multivariate logistic regression analysis adjusted for possible risk factors indicated that the average, standard deviation, average real variability, and highest blood pressure, but not the coefficient of variation of systolic blood pressure, were significant predictors of 'high blood pressure'.
Conclusion:
Increased year-to-year blood pressure variability predicts the risk of hypertension in the general normotensive population. The highest blood pressure in the preceding years may also be a strong predictor of the risk of hypertension.
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