Within-visit, visit-to-visit BP variability predict all-cause mortality

Visit-to-visit and sustained high within-visit blood pressure variability (BPV) are significantly associated with all-cause mortality, according to a study.

BPV is a common physiological phenomenon, but the relationship of within-visit and visit-to-visit BPV with all-cause mortality had not been previously examined. To address this, the authors performed a retrospective analysis of BPV among 11,721 adults who underwent BP measurement on three occasions within a period of 6 months.

The standard deviation and maximum–minimum difference between measures were used to quantify within-visit and visit-to-visit variability. The predictive effect of BPV on all-cause mortality was assessed using Kaplan–Meier survival curves and Cox regression analysis.

Participants in the top quintile of within-visit and visit-to-visit BPV and those with sustained high within-visit variability were found to have a significantly higher incidence of all-cause mortality. However, after adjustment in Cox regression models, the association of within-visit variability with all-cause mortality was attenuated.

In addition, the hazard ratio for mortality rose from 48 percent to 55 percent for the top quintile of visit-to-visit BPV and from 56 percent to 61 percent for sustained high within-visit variability. The statistically increased risk of mortality persisted even if visit-to-visit BPV was added to the model, including consistency of within-visit BPV and vice versa.

“Our findings underlined the clinical significance of achieving stable BP in an effective plan of hypertension management,” the authors said.