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China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients
BACKGROUND: The optimal range of blood pressure variability remains unclear. We aimed to stratify the degree of risk of stroke based on visit‐to‐visit systolic blood pressure (SBP) variability in a large Chinese hypertensive population in 32 communities. METHODS AND RESULTS: We retrospectively analy...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523997/ https://www.ncbi.nlm.nih.gov/pubmed/28288974 http://dx.doi.org/10.1161/JAHA.116.004350 |
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author | Men, Xi Sun, Wei Fan, Fangfang Zhao, Min Huang, Xiao Wang, Yu Liu, Lishun Liu, Ran Sun, Weiping Peng, Qing Qin, Xianhui Tang, Genfu Li, Jianping Zhang, Yan Cai, Yefeng Hou, Fan Fan Wang, Binyan Xu, Xiping Cheng, Xiaoshu Sun, Ningling Huang, Yining Huo, Yong |
author_facet | Men, Xi Sun, Wei Fan, Fangfang Zhao, Min Huang, Xiao Wang, Yu Liu, Lishun Liu, Ran Sun, Weiping Peng, Qing Qin, Xianhui Tang, Genfu Li, Jianping Zhang, Yan Cai, Yefeng Hou, Fan Fan Wang, Binyan Xu, Xiping Cheng, Xiaoshu Sun, Ningling Huang, Yining Huo, Yong |
author_sort | Men, Xi |
collection | PubMed |
description | BACKGROUND: The optimal range of blood pressure variability remains unclear. We aimed to stratify the degree of risk of stroke based on visit‐to‐visit systolic blood pressure (SBP) variability in a large Chinese hypertensive population in 32 communities. METHODS AND RESULTS: We retrospectively analyzed the data of 20 702 hypertensive patients from the China Stroke Primary Prevention Trial. The participants were randomized into 2 treatment groups to receive either enalapril or enalapril plus folic acid. Their blood pressures were measured every 3 months. The outcome was the first stroke. Three parameters of SBP variability were calculated: standard deviation, coefficient of variation, and average real variability. The records of first 4, 6, 8, 10 and 12 visits at which SBP was measured were used to calculate SBP variability and to predict subsequent stroke risk in adjusted Cox regression models. After median follow‐up of 4.5 years, 597 patients had experienced stroke. Visit‐to‐visit SBP variability was an independent predictor of subsequent stroke (eg, the hazard ratio for the highest quintile of average real variability [22.67–61.07 mm Hg] over 6 visits was 1.55, 95% CI 1.07–2.25, P=0.021), independent of mean SBP over the follow‐up period. Its value was more predictive when more blood pressure records were used. CONCLUSIONS: Visit‐to‐visit SBP variability is an independent predictor of primary stroke in Chinese hypertensive patients. This predictive value depends on the number of blood pressure measurements used to calculate variability but is independent of mean SBP. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00794885. |
format | Online Article Text |
id | pubmed-5523997 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-55239972017-08-15 China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients Men, Xi Sun, Wei Fan, Fangfang Zhao, Min Huang, Xiao Wang, Yu Liu, Lishun Liu, Ran Sun, Weiping Peng, Qing Qin, Xianhui Tang, Genfu Li, Jianping Zhang, Yan Cai, Yefeng Hou, Fan Fan Wang, Binyan Xu, Xiping Cheng, Xiaoshu Sun, Ningling Huang, Yining Huo, Yong J Am Heart Assoc Original Research BACKGROUND: The optimal range of blood pressure variability remains unclear. We aimed to stratify the degree of risk of stroke based on visit‐to‐visit systolic blood pressure (SBP) variability in a large Chinese hypertensive population in 32 communities. METHODS AND RESULTS: We retrospectively analyzed the data of 20 702 hypertensive patients from the China Stroke Primary Prevention Trial. The participants were randomized into 2 treatment groups to receive either enalapril or enalapril plus folic acid. Their blood pressures were measured every 3 months. The outcome was the first stroke. Three parameters of SBP variability were calculated: standard deviation, coefficient of variation, and average real variability. The records of first 4, 6, 8, 10 and 12 visits at which SBP was measured were used to calculate SBP variability and to predict subsequent stroke risk in adjusted Cox regression models. After median follow‐up of 4.5 years, 597 patients had experienced stroke. Visit‐to‐visit SBP variability was an independent predictor of subsequent stroke (eg, the hazard ratio for the highest quintile of average real variability [22.67–61.07 mm Hg] over 6 visits was 1.55, 95% CI 1.07–2.25, P=0.021), independent of mean SBP over the follow‐up period. Its value was more predictive when more blood pressure records were used. CONCLUSIONS: Visit‐to‐visit SBP variability is an independent predictor of primary stroke in Chinese hypertensive patients. This predictive value depends on the number of blood pressure measurements used to calculate variability but is independent of mean SBP. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00794885. John Wiley and Sons Inc. 2017-03-13 /pmc/articles/PMC5523997/ /pubmed/28288974 http://dx.doi.org/10.1161/JAHA.116.004350 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial (http://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Men, Xi Sun, Wei Fan, Fangfang Zhao, Min Huang, Xiao Wang, Yu Liu, Lishun Liu, Ran Sun, Weiping Peng, Qing Qin, Xianhui Tang, Genfu Li, Jianping Zhang, Yan Cai, Yefeng Hou, Fan Fan Wang, Binyan Xu, Xiping Cheng, Xiaoshu Sun, Ningling Huang, Yining Huo, Yong China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients |
title | China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients |
title_full | China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients |
title_fullStr | China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients |
title_full_unstemmed | China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients |
title_short | China Stroke Primary Prevention Trial: Visit‐to‐Visit Systolic Blood Pressure Variability Is an Independent Predictor of Primary Stroke in Hypertensive Patients |
title_sort | china stroke primary prevention trial: visit‐to‐visit systolic blood pressure variability is an independent predictor of primary stroke in hypertensive patients |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5523997/ https://www.ncbi.nlm.nih.gov/pubmed/28288974 http://dx.doi.org/10.1161/JAHA.116.004350 |
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