Prognostic Relevance of Short-Term Blood Pressure Variability. The Spanish ABPM Registry

Area of Science:

• Cardiology
• Hypertension Research
• Clinical Epidemiology

Background:

• The prognostic significance of short-term blood pressure (BP) variability in hypertension remains unclear.
• Evaluating the association between BP variability and mortality is crucial for patient outcomes.

Purpose of the Study:

• To assess the relationship between short-term BP variability and all-cause and cardiovascular mortality.
• To investigate prognostic markers in a large cohort of hypertensive patients.

Main Methods:

• Analysis of 59,124 patients from the Spanish Ambulatory Blood Pressure Monitoring Registry (2004-2014).
• Calculation of various BP variability metrics (SD, coefficient of variation, weighted SD, average real variability, BP variability ratio) from 24-hour ambulatory BP monitoring.
• Cox regression models were used to assess associations with mortality, adjusted for confounders and BP levels.

Main Results:

• Patients with higher BP variability exhibited increased all-cause and cardiovascular mortality.
• Several BP variability metrics, including systolic and diastolic daytime and weighted SD/coefficient of variation, average real variability, and systolic nighttime SD, were significantly associated with mortality.
• Specific thresholds for daytime SD (≥13 mmHg), nighttime SD (≥12 mmHg), weighted SD (≥12 mmHg), and average real variability (≥10 mmHg) were independently linked to mortality.

Conclusions:

• Short-term blood pressure variability demonstrates a significant, albeit modest, association with all-cause and cardiovascular mortality in hypertensive individuals.
• These findings underscore the importance of considering BP variability in risk stratification and management of hypertension.