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Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial

We aim to determine if visit‐to‐visit blood pressure variability (BPV) adds prognostic value for all‐cause mortality independently of the Framingham risk score (FRS) in the systolic blood pressure intervention trial (SPRINT). We defined BPV as variability independent of the mean (VIM) and the differ...

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Autores principales: Cheng, Yi, Li, Jian, Ren, Xinping, Wang, Dan, Yang, Yulin, Miao, Ya, Sheng, Chang‐Sheng, Tian, Jingyan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8678842/
https://www.ncbi.nlm.nih.gov/pubmed/34216524
http://dx.doi.org/10.1111/jch.14314
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author Cheng, Yi
Li, Jian
Ren, Xinping
Wang, Dan
Yang, Yulin
Miao, Ya
Sheng, Chang‐Sheng
Tian, Jingyan
author_facet Cheng, Yi
Li, Jian
Ren, Xinping
Wang, Dan
Yang, Yulin
Miao, Ya
Sheng, Chang‐Sheng
Tian, Jingyan
author_sort Cheng, Yi
collection PubMed
description We aim to determine if visit‐to‐visit blood pressure variability (BPV) adds prognostic value for all‐cause mortality independently of the Framingham risk score (FRS) in the systolic blood pressure intervention trial (SPRINT). We defined BPV as variability independent of the mean (VIM) and the difference of maximum minus minimum (MMD) of the systolic blood pressure (SBP). Multivariable Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI). Based on FRS stratification, there were 1035, 2911, and 4050 participants in the low‐, intermediate‐, and high‐risk groups, respectively. During the trial, 230 deaths occurred since the 12th month with an average follow‐up of 2.5 years. In continuous analysis, 1‐SD increase of SBP VIM and MMD were significantly associated with all‐cause mortality (HR 1.18, 95% CI 1.05–1.32, p = .005; and HR 1.21, 95% CI 1.09–1.35, p < .001, respectively). In category analysis, the highest quintile of BPV compared with the lowest quintile had significantly higher risk of all‐cause mortality. Cross‐tabulation analysis showed that the 3rd tertile of SBP VIM in the high‐risk group had the highest HR of all‐cause mortality in total population (HR 4.99; 95% CI 1.57–15.90; p = .007), as well as in intensive‐therapy group (HR 7.48; 95% CI 1.01–55.45; p = .05) analyzed separately. Cross‐tabulation analysis of SBP MMD had the same pattern as VIM showed above. In conclusion, visit‐to‐visit BPV was an independent predictor of all‐cause mortality, when accounting for conventional risk factors or FRS. BPV combined with FRS conferred an increased risk for all‐cause mortality in the SPRINT trial.
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spelling pubmed-86788422021-12-23 Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial Cheng, Yi Li, Jian Ren, Xinping Wang, Dan Yang, Yulin Miao, Ya Sheng, Chang‐Sheng Tian, Jingyan J Clin Hypertens (Greenwich) Blood Pressure Variability We aim to determine if visit‐to‐visit blood pressure variability (BPV) adds prognostic value for all‐cause mortality independently of the Framingham risk score (FRS) in the systolic blood pressure intervention trial (SPRINT). We defined BPV as variability independent of the mean (VIM) and the difference of maximum minus minimum (MMD) of the systolic blood pressure (SBP). Multivariable Cox proportional hazards models were used to estimate the hazard ratio (HR) and 95% confidence interval (CI). Based on FRS stratification, there were 1035, 2911, and 4050 participants in the low‐, intermediate‐, and high‐risk groups, respectively. During the trial, 230 deaths occurred since the 12th month with an average follow‐up of 2.5 years. In continuous analysis, 1‐SD increase of SBP VIM and MMD were significantly associated with all‐cause mortality (HR 1.18, 95% CI 1.05–1.32, p = .005; and HR 1.21, 95% CI 1.09–1.35, p < .001, respectively). In category analysis, the highest quintile of BPV compared with the lowest quintile had significantly higher risk of all‐cause mortality. Cross‐tabulation analysis showed that the 3rd tertile of SBP VIM in the high‐risk group had the highest HR of all‐cause mortality in total population (HR 4.99; 95% CI 1.57–15.90; p = .007), as well as in intensive‐therapy group (HR 7.48; 95% CI 1.01–55.45; p = .05) analyzed separately. Cross‐tabulation analysis of SBP MMD had the same pattern as VIM showed above. In conclusion, visit‐to‐visit BPV was an independent predictor of all‐cause mortality, when accounting for conventional risk factors or FRS. BPV combined with FRS conferred an increased risk for all‐cause mortality in the SPRINT trial. John Wiley and Sons Inc. 2021-07-03 /pmc/articles/PMC8678842/ /pubmed/34216524 http://dx.doi.org/10.1111/jch.14314 Text en © 2021 The Authors. The Journal of Clinical Hypertension published by Wiley Periodicals LLC https://creativecommons.org/licenses/by/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Blood Pressure Variability
Cheng, Yi
Li, Jian
Ren, Xinping
Wang, Dan
Yang, Yulin
Miao, Ya
Sheng, Chang‐Sheng
Tian, Jingyan
Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial
title Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial
title_full Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial
title_fullStr Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial
title_full_unstemmed Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial
title_short Visit‐to‐visit office blood pressure variability combined with Framingham risk score to predict all‐cause mortality: A post hoc analysis of the systolic blood pressure intervention trial
title_sort visit‐to‐visit office blood pressure variability combined with framingham risk score to predict all‐cause mortality: a post hoc analysis of the systolic blood pressure intervention trial
topic Blood Pressure Variability
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8678842/
https://www.ncbi.nlm.nih.gov/pubmed/34216524
http://dx.doi.org/10.1111/jch.14314
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