Visit-to-visit blood pressure variability and cardiovascular and kidney diseases
Abstract
In healthy people and patients with hypertension, blood pressure varies between clinic visits every several days, a week, or a month apart. Although long thought to be an artifact, recent data suggest that visit-to-visit variability of blood pressure is reproducible and has independent association with cardiovascular outcomes and mortality. There currently is no consensus on how to define blood pressure variability best. The most common metric used is standard deviation of mean blood pressure, variation independent of the mean and average real variability. Blood pressure variability is higher in female, older age and patients with hypertension, with cardiovascular diseases, with diabetes mellitus and chronic kidney disease. Therefore, we are not sure if higher blood pressure variability is the only marker of arterial stiffness and consequence of end organ damage or prognostic indicator of cardiovascular events. We also do not know whether reducing blood pressure variability would reduce the risk of cardiovascular outcomes. However, the number of studies on blood pressure variability is growing exponentially and perhaps in the near future, high blood pressure variability will also be the goal of hypertension therapy.
Keywords: blood pressure variabilitycardiovascular diseaseskidney failure
References
- Kabat M. Hipertensjologia. Patogeneza, diagnostyka i leczenie nadciśnienia tętniczego. Ed. Więcek A., Januszewicz A., Szczepańska- -Sadowska E., Prejbisz A. Medycyna Praktyczna. 2015: 154.
- Alpérovitch A, Lacombe JM, Hanon O, et al. Relationship between blood pressure and outdoor temperature in a large sample of elderly individuals: the Three-City study. Arch Intern Med. 2009; 169(1): 75–80.
- Muntner P, Joyce C, Levitan EB, et al. Reproducibility of visit-to-visit variability of blood pressure measured as part of routine clinical care. J Hypertens. 2011; 29(12): 2332–2338.
- Hussein WF, Chang TI. Visit-to-Visit Variability of Systolic Blood Pressure and Cardiovascular Disease. Curr Hypertens Rep. 2015; 17(3): 14.
- Mancia G, Parati G, Castiglioni P, et al. Daily life blood pressure changes are steeper in hypertensive than in normotensive subjects. Hypertension. 2003; 42(3): 277–282.
- Yadav S, Cotlarciuc I, Munroe PB, et al. International Stroke Genetics Consortium. Genome-wide analysis of blood pressure variability and ischemic stroke. Stroke. 2013; 44(10): 2703–2709.
- Mancia G, Facchetti R, Parati G, et al. Visit-to-visit blood pressure variability, carotid atherosclerosis, and cardiovascular events in the European Lacidipine Study on Atherosclerosis. Circulation. 2012; 126(5): 569–578.
- Muntner P, Shimbo D, Tonelli M, et al. The relationship between visit-to-visit variability in systolic blood pressure and all-cause mortality in the general population: findings from NHANES III, 1988 to 1994. Hypertension. 2011; 57(2): 160–166.
- Zakopoulos NA, Tsivgoulis G, Barlas G, et al. Time rate of blood pressure variation is associated with increased common carotid artery intima-media thickness. Hypertension. 2005; 45(4): 505–512.
- Grassi G, Seravalle G, Maloberti A, et al. Within-visit BP variability, cardiovascular risk factors, and BP control in central and eastern Europe: findings from the BP-CARE study. J Hypertens. 2015; 33(11): 2250–2256.
- Chowdhury EK, Owen A, Krum H, et al. Second Australian National Blood Pressure Study Management Committee. Systolic blood pressure variability is an important predictor of cardiovascular outcomes in elderly hypertensive patients. J Hypertens. 2014; 32(3): 525–533.
- Gorostidi M, Sarafidis P, Sierra AL. Blood pressure variability increases with advancing chronic kidney diseases stage. A cross-sectional analysis of 14, 382 hypertensive patients from Spain. J Hypertens. 2015; 33(Suppl. 1): e40.
- Tanner RM, Shimbo D, Dreisbach AW, et al. Association between 24-hour blood pressure variability and chronic kidney disease: a cross-sectional analysis of African Americans participating in the Jackson heart study. BMC Nephrol. 2015; 16: 84.
- Shimbo D, Newman JD, Aragaki AK, et al. Association between annual visit-to-visit blood pressure variability and stroke in postmenopausal women: data from the Women's Health Initiative. Hypertension. 2012; 60(3): 625–630.
- Rothwell PM, Howard SC, Dolan E, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010; 375(9718): 895–905.
- Muntner P, Whittle J, Lynch AI, et al. Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease, Stroke, Heart Failure, and Mortality: A Cohort Study. Ann Intern Med. 2015; 163(5): 329–338.
- Vishram JKK, Dahlöf B, Devereux RB, et al. Blood pressure variability predicts cardiovascular events independently of traditional cardiovascular risk factors and target organ damage: a LIFE substudy. J Hypertens. 2015; 33(12): 2422–2430.
- Satoh M, Hosaka M, Asayama K, et al. Association between N-terminal pro B-type natriuretic peptide and day-to-day blood pressure and heart rate variability in a general population: the Ohasama study. J Hypertens. 2015; 33(8): 1536–1541.
- Hastie CE, Jeemon P, Coleman H, et al. Long-term and ultra long-term blood pressure variability during follow-up and mortality in 14,522 patients with hypertension. Hypertension. 2013; 62(4): 698–705.
- Takao T, Kimura K, Suka M, et al. Relationships between the risk of cardiovascular disease in type 2 diabetes patients and both visit-to-visit variability and time-to-effect differences in blood pressure. J Diabetes Complications. 2015; 29(5): 699–706.
- Chang TI, Tabada GH, Yang J, et al. Visit-to-visit variability of blood pressure and death, end-stage renal disease, and cardiovascular events in patients with chronic kidney disease. J Hypertens. 2016; 34(2): 244–252.
- Yano Y, Fujimoto S, Kramer H, et al. Long-Term Blood Pressure Variability, New-Onset Diabetes Mellitus, and New-Onset Chronic Kidney Disease in the Japanese General Population. Hypertension. 2015; 66(1): 30–36.
- Yokota K, Sakurada T, Koitabashi K, et al. Association Between Residual Kidney Function and Visit-to-Visit Blood Pressure Variability in Peritoneal Dialysis Patients. Adv Perit Dial. 2015; 31: 49–53.
- Stergiou GS, Ntineri A, Kollias A, et al. Blood pressure variability assessed by home measurements: a systematic review. Hypertens Res. 2014; 37(6): 565–572.
- Diaz KM, Tanner RM, Falzon L, et al. Visit-to-visit variability of blood pressure and cardiovascular disease and all-cause mortality: a systematic review and meta-analysis. Hypertension. 2014; 64(5): 965–982.
- Taylor KS, Heneghan CJ, Stevens RJ, et al. Heterogeneity of prognostic studies of 24-hour blood pressure variability: systematic review and meta-analysis. PLoS One. 2015; 10(5): e0126375.
- Boggia J, Asayama K, Li Y, et al. Cardiovascular risk stratification and blood pressure variability on ambulatory and home blood pressure measurement. Curr Hypertens Rep. 2014; 16(9): 470.
- Coulson JM. The relationship between blood pressure variability and catecholamine metabolites: a pilot study. J Hum Hypertens. 2015; 29(1): 50–52.
- Diaz KM, Veerabhadrappa P, Kashem MA, et al. Visit-to-visit and 24-h blood pressure variability: association with endothelial and smooth muscle function in African Americans. J Hum Hypertens. 2013; 27(11): 671–677.
- Liu Q, Liu Y, Han J, et al. [Impact of visit-to-visit blood pressure variability on vascular function in elderly hypertensive patients]. Nan Fang Yi Ke Da Xue Xue Bao. 2015; 35(9): 1320–1324.