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The Effect of Blood Pressure Variability on Hypertensive Patients’ Prognosis [Anatol J Cardiol]
Anatol J Cardiol. Ahead of Print: AJC-00905 | DOI: 10.14744/AnatolJCardiol.2019.00905  

The Effect of Blood Pressure Variability on Hypertensive Patients’ Prognosis

Ziad A Taher1, Waleed W Khayyat2, Marwan M Balubaid2, Mohammed Y Tashkandi2, Haifaa A Khayyat3, Abdulhalim Jamal Kinsara1
1Department of cardiology, Ministry of National Guard health Affair, King Saud Bin Abdulaziz University for Health Sciences, COM-WR.King Abdullah International medical research center. Jeddah, Saudi Arabia.
2King Saud Bin Abdulaziz University for Health Sciences, COM-WR, Jeddah, Saudi Arabia.
3King Fahd Hospital

Aim:
Our study aims to compare the effects of blood pressure variability (BPV) during ambulatory blood pressure (ABPM) and visit-to-visit measurements in predicting future cardiovascular complications among hypertensive patients.
Method:
This is a retrospective case-control study of patients with hypertension over 10 years. All adult patients with at least one recorded ABPM, and at least three recorded visit measurements were included. Patients with incomplete ABPM readings, a history of a tested outcome or occurrence of any of the tested outcomes within the measurement period were excluded. The outcome was development of any of the following acute coronary syndrome (ACS), chronic ischemic heart disease (IHD), heart failure (HF), or stroke.
Results:
Of 305 total cases reviewed, 152 were included. Mean follow-up was 6.6 ±2.3 years. The mean age was 53.5±14.3 year, 82 (53.9%) were males. Risk factors included diabetes mellitus (53.9%), dyslipidemia (39.5%), obesity (16.4%), and smoking (8.6%). Comorbidities included stroke (2%), ACS (8.6%), IHD (20.4%), HF (2.6%), and renal failure (1.3%). 22.4 % of the included developed one or more of the measured complications. The variation of the daytime systolic ABP had been found to predict future risk of developing IHD (OR=1.94; 95% CI, 1.09-3.45; P=0.025). Moreover, IHD was associated with night-time systolic SD in ABPM (OR=1.23; 95% CI, 1.00-1.51; P=0.048). On the other side, ACS was found to be associated with systolic SD in visit-to-visit measurement (OR=1.10; 95% CI, 1.01-1.21; P=0.04).
Conclusion:
Hypertensive patients with high variability of daytime and night-time systolic SD in ABPM are more likely to have IHD. Whereas, having high variability in systolic SD in visit-to-visit measurements is associated with developing ACS

Keywords: Hypertension, Prognosis, Ambulatory blood pressure monitoring, variability, visit-to-visit




Corresponding Author: Abdulhalim Jamal Kinsara, Saudi Arabia


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