Open AccessVisit‐to‐Visit Blood Pressure Variability and Cardiovascular Death in the Systolic Hypertension in the Elderly Program
Author(s) -
Kostis John B.,
Sedjro Jeanine E.,
Cabrera Javier,
Cosgrove Nora M.,
Pantazopoulos John S.,
Kostis William J.,
Pressel Sara L.,
Davis Barry R.
Publication year - 2014
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/jch.12230
Subject(s) - medicine , blood pressure , placebo , diabetes mellitus , body mass index , cardiology , adverse effect , endocrinology , alternative medicine , pathology
Most studies of an association of visit‐to‐visit variability of blood pressure with increased risk of future adverse cardiovascular events are of short duration and rarely include a placebo group. Using data from the double‐blind, placebo‐controlled S ystolic H ypertension in the E lderly P rogram, the authors examined mortality from cardiovascular causes up to 17 years of follow‐up using the N ational D eath I ndex. Visit‐to‐visit blood pressure variability was associated with cardiovascular death after adjustment for sex, age, serum creatinine, diabetes, body mass index, smoking status, left ventricular failure, and high‐density lipoprotein cholesterol. The relationship was significantly stronger in the active treatment group compared with the placebo group. Although this could be the result of an effect of the medications used unrelated to visit‐to‐visit variability, the data are compatible with the hypothesis that inconsistent adherence leading to missing active medication doses may be an additional explanation for the relationship of visit‐to‐visit variability with cardiovascular death.