Open AccessWithin‐Visit Variability of Blood Pressure and All‐Cause and Cardiovascular Mortality Among US Adults
Author(s) -
Muntner Paul,
Levitan Emily B.,
Reynolds Kristi,
Mann Devin M.,
Tonelli Marcello,
Oparil Suzanne,
Shimbo Daichi
Publication year - 2012
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2011.00581.x
Subject(s) - medicine , hazard ratio , blood pressure , confidence interval , standard deviation , demography , diastole , cardiology , statistics , mathematics , sociology
J Clin Hypertens (Greenwich) . 2012;14:165–171. ©2012 Wiley Periodicals, Inc. The association between within‐visit variability of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and all‐cause and cardiovascular (CVD) mortality was examined using the Third National Health and Nutrition Survey (n=15,317). Three SBP and DBP readings were taken by physicians during a single medical evaluation. Within‐visit variability for each participant was defined using the standard deviation of SBP and DBP across these measurements. Mortality was assessed over 14 years (n=3848 and n=1684 deaths from all causes and CVD, respectively). After age, sex, and race‐ethnicity adjustment, the hazard ratios (95% confidence intervals) for all‐cause mortality associated with the 4 highest quintiles of within‐visit standard deviation of SBP (2.00–2.99 mm Hg, 3.00–3.99 mm Hg, 4.00–5.29 mm Hg, and ≥5.30 mm Hg) compared with participants in the lowest quintile of within‐visit standard deviation of SBP (<2.0 mm Hg) were 1.04 (0.87–1.26), 1.09 (0.92–1.29), 1.06 (0.88–1.28), and 1.13 (0.95–1.33), respectively ( P= .136). The analogous hazard ratios for CVD mortality were 0.95 (0.69–1.32), 0.96 (0.67–1.36), 0.95 (0.74–1.23), and 1.04 (0.80–1.35), respectively ( P =.566). No association with mortality was present after further adjustment and when modeling within‐visit standard deviation of SBP as a continuous variable. Standard deviation of DBP was not associated with mortality.