Night-time SBP variability linked to CV events in hypertensive patients

Variability of night-time systolic blood pressure (SBP) is a significant predictor of the incidence of cardiovascular (CV) events in patients with hypertension, independently of average 24-h BP and arterial stiffness, according to a study.

“Short-term BP variability derived from 24-h ambulatory monitoring is associated with poor CV prognosis,” the authors said. “Arterial stiffness is a powerful marker of CV risk, which may influence BP variability.”

In this study, the prognostic value of BP variability was examined in a Bordeaux cohort of hypertensive patients based on 24-h ambulatory measurements and adjusted for arterial stiffness. A total of 969 patients aged 54±14 years with an average follow-up of 120±78 months and 178 CV recorded events met the eligibility criteria.

Inclusion criteria were as follows: 24-h ambulatory BP monitoring at baseline with measurements every 15’ day and night, determination of wake-up time and bedtime, and assessment of arterial stiffness with monitoring of Korotkoff sound arrival time.

Univariate survival analyses revealed that the standard deviations of day, night, and 24-h SBP correlated with the occurrence of CV events. The standard deviation of night-time SBP had the most robust association with the outcome variable and was entered into multivariate analyses.

Multivariate analyses showed that night-time SBP variability remained significantly correlated with the occurrence of CV events after adjusting for major CV risk factors, 24-h SBP, and arterial stiffness. No significant association was found for BP variability and arterial stiffness.