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    Visit-to-visit (long-term) and ambulatory (short-term) blood pressure variability to predict mortality in an elderly hypertensive population

    Access Status
    Fulltext not available
    Authors
    Chowdhury, Enayet
    Wing, L.
    Jennings, G.
    Beilin, L.
    Reid, Christopher
    Date
    2018
    Type
    Journal Article
    
    Metadata
    Show full item record
    Citation
    Chowdhury, E. and Wing, L. and Jennings, G. and Beilin, L. and Reid, C. 2018. Visit-to-visit (long-term) and ambulatory (short-term) blood pressure variability to predict mortality in an elderly hypertensive population. Journal of Hypertension. 36 (5): pp. 1059-1067.
    Source Title
    Journal of Hypertension
    DOI
    10.1097/HJH.0000000000001652
    ISSN
    0263-6352
    School
    School of Public Health
    URI
    http://hdl.handle.net/20.500.11937/73360
    Collection
    • Curtin Research Publications
    Abstract

    © Copyright 2018 Wolters Kluwer Health, Inc. All rights reserved. Objectives: To explore the association of different types of blood pressure (BP) variability measures estimated from either short-term ambulatory reading-to-reading or long-term clinic visit-to-visit BP records with long-term survival in an elderly treated hypertensive population. Methods: A subset of patients (n = 508) aged at least 65-years was studied from the Second Australian National Blood Pressure study. We estimated SBP and DBP BP variability as the SD of ambulatory (24-h, daytime, night-time) and clinic visit-to-visit BP directly from all corresponding on-treatment within-individual BP records. Ambulatory 'weighted day-night' variability was calculated as a weighted mean of daytime and night-time SD. Cox-proportional hazard models adjusted for baseline risk factors (Model 1) and corresponding on-treatment BP (Model 2) or average night-time SBP (best predictive BP measure for outcome) (Model 3) were used to determine the relationship between long-term outcome and BP variability. Results: Over a median of 10.6 years, 101 patients died from any cause, of which 51 deaths were cardiovascular. We observed increase in 'daytime' and 'weighted day-night' SBP/DBP variability was significantly associated with increased all-cause mortality in all models. For cardiovascular mortality, only 'weighted day-night' SBP variability significantly predicted risk in all models (Model 3 hazard ratio: 1.09, 95% confidence interval: 1.00-1.19, P = 0.04). Long-term BP variability was not associated with any outcome. On direct comparison, both 'daytime' and 'weighted day-night' BP variability measures provided similar prognostic information. Conclusion: Short-term 'daytime' and 'weighted day-night' SBP variability from ambulatory BP recordings was a better predictor of mortality in elderly treated hypertensive patients than long-term BP variability from visit-to-visit BP recordings.

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