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Blood Pressure Variability and Risk of Cardiovascular Events and Mortality in Real-World Clinical Settings
Hsin-Lun Li1, Hung-Ju Lin2,3, Chih-Hsin Muo4
1Department of Applied Mathematics National Sun Yet-sen University Kaohsiung Taiwan.
Journal of the American Heart Association
|May 26, 2025
Summary
Visit-to-visit blood pressure (BP) variability is linked to higher risks of cardiovascular events and death. This study confirms BP variability is a significant predictor in real-world healthcare settings.
Area of Science:
- Cardiology
- Public Health
- Data Science
Background:
- Long-term blood pressure (BP) variability measurement's real-world applicability is not well understood.
- Electronic health records (EHRs) offer a valuable resource for studying BP variability.
- Understanding BP variability is crucial for predicting cardiovascular outcomes.
Purpose of the Study:
- To investigate the association between visit-to-visit BP variability and the risk of cardiovascular events.
- To evaluate the link between BP variability and all-cause mortality.
- To determine the clinical applicability of BP variability indices in real-world healthcare.
Main Methods:
- Retrospective cohort study utilizing EHR data from 16,945 adults in Taiwan (2012-2017).
- Calculated BP variability using variability independent of the mean (VIM) and average real variability.
- Employed Cox proportional hazards models to assess associations with cardiovascular events and all-cause mortality through 2020.
Main Results:
- Increased BP variability, measured by VIM and average real variability, was associated with a higher risk of cardiovascular events and all-cause mortality.
- Adjusted hazard ratios per interquartile range increase in systolic BP variability were 1.24 (VIM) and 1.11 (average real variability).
- Similar associations were observed for diastolic BP variability and all-cause mortality, with consistent findings across subgroups.
Conclusions:
- Visit-to-visit BP variability is an independent predictor of cardiovascular events and all-cause mortality.
- BP variability indices demonstrate applicability in real-world healthcare settings.
- These findings support the integration of BP variability monitoring into routine clinical practice.
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