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Alexander Butkevich, Robert A. Phillips, P-46: Predictors of blood pressure variability, American Journal of Hypertension, Volume 14, Issue S1, April 2001, Page 45A, https://doi.org/10.1016/S0895-7061(01)01524-2
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Abstract
A significant body of evidence suggests that increased BP variability, as assessed by 24-hour ambulatory BP monitoring (ABPM), may be an additional risk factor for cardiovascular events. However, factors affecting BP variability have not been sufficiently studied, and very little is known about blood pressure variability in subjects receiving antihypertensive treatment. We examined the parameters that affect BP variability in a multiethnic population.
We analyzed 24-hour ABPM recording of 657 consecutive patients, 310 treated and 347 untreated referred for ABPM to our institution. The relationship between daytime (7AM-10PM) BP variability and age, gender, BMI, daytime BP, presence or absence of antihypertensive therapy, control of BP and dipping pattern were examined using multiple regression analysis.
The study population consisted of 153 subjects normotensive by ABPM, 111 subjects on antihypertensive therapy with BP optimally controlled (daytime BP<135/85 mmHg in both groups); 194 subjects were hypertensive and untreated, and 199 treated subjects had BP suboptimally controlled (daytime BP≥135/85 mmHg in both groups). Age, sex, BMI and daytime systolic and diastolic BP were significantly correlated with systolic BP variability (R=0.504, P<0.001). Diastolic BP variability was significantly correlated with BMI, sex, systolic BP, use of antihypertensive medications and day-night systolic BP difference. (R=0.335, P<0.001). Use of antihypertensive medications did not significantly affect systolic BP variability, when adjusted for age, sex and mean BP.
Thus, different factors influence systolic and diastolic BP variability. Although BP variability is affected by unmodifiable factors, such as age and gender, we identified several factors that are amenable to intervention. Control of these factors is likely to reduce BP variability, which may result in reduction of the risk of cardiovascular events. Further prospective studies are needed to investigate the effects of control of these factors on BP variability.
