Predictive value of different long-term (10-year) blood pressure parameters variability in cardiovascular disease: A...

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Long-term blood pressure variability is increasingly recognized as a significant factor in cardiovascular health.
• Understanding the independent predictive value of systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) variability is crucial for risk assessment.

Purpose of the Study:

• To compare the predictive capabilities of long-term SBP, DBP, and PP variability for incident cardiovascular diseases (CVDs).
• To evaluate the incremental predictive value of blood pressure variability when integrated into the established China-PAR risk prediction model.

Main Methods:

• A prospective cohort study involving 44,938 participants was conducted.
• Participants were stratified into quartiles based on SBP, DBP, and PP variability over a 10-year period.
• Cox proportional hazards regression and the China-PAR model were utilized to assess CVD risk prediction.

Main Results:

• Higher quartiles of SBP, DBP, and PP variability were associated with significantly increased CVD risk (HRs ranging from 1.25 to 1.33 compared to the lowest quartile).
• Incorporating SBP, DBP, and PP variability into the China-PAR model improved its predictive accuracy, with SBP variability showing the greatest enhancement (C-indices 0.6866, 0.6787, 0.6822 respectively).
• A significant interaction between age and blood pressure variability was observed for all measures.

Conclusions:

• Elevated long-term variability in SBP, DBP, and PP independently predicts higher CVD risk, irrespective of average blood pressure levels.
• Systolic blood pressure variability demonstrates the strongest capacity to improve CVD risk prediction within the China-PAR model.
• Blood pressure variability is a critical, independent risk factor for cardiovascular events.