Blood pressure variability and risk of cardiovascular events and death in patients with hypertension and different baseline risks
Primary result · CV eventsResult — go to the resultHazard ratio 2.1 95% CI 1.7–2.4Authors' conclusion
Higher visit-to-visit systolic blood pressure variability is associated with increased risk of cardiovascular events in patients with hypertension, irrespective of baseline risk of cardiovascular events. Associations were stronger in younger patients and in those with lower mean systolic blood pressure.
Study context
- Population
- Patients with hypertension and different CV risks in the Valsartan Antihypertensive Long-term Use Evaluation trial (valsartan vs amlodipine), ≥3 visits and no events in first 6 months
- Participants
- 13,803 patients
- Comparison
- Highest vs lowest quintile of visit-to-visit SBP variability
- Primary endpoint
- CV events and death
- Follow-up
- Mean 4.2 years
Primary result
CV events
Hazard ratio
2.1
95% CI 1.7–2.4
P < 0.0001
Highest quintilevs Lowest quintile
HR 2.1 (95% CI 1.7–2.4); P < 0.0001
As reported in the abstract
- CV events overall
- 1557 (11.3%)
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Death, per 5 mmHg increase in SD of SBP (continuous) | 1.10 (1.04–1.17) | P = 0.002 | |
| 0.512Hazard ratio (log scale) |
- Death, per 5 mmHg increase in SD of SBP (continuous) — Deaths overall
- 1089 (7.9%)
Subgroups
- Associations stronger in younger patients and patients with lower SBP; similar across baseline risks, except higher risk of death with established CVD
Original publication
Blood pressure variability and risk of cardiovascular events and death in patients with hypertension and different baseline risks. Eur Heart J. Published 20 January 2018. doi:10.
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