44. Correlation of Short-term Blood Pressure Variability and Cardiovascular Outcomes

Abstract

Background: Short-term blood pressure variability (BPV) is defined as the average variation in blood pressure throughout the day as measured by the ambulatory blood pressure monitoring (ABPM). Excessive BPV has potential to trigger cardiovascular events, especially in high-risk cardiovascular patients. Short-term BPV has been used as risk stratification but it is still unclear which subset of BPV is more significant to predict cardiovascular (CV) outcomes, especially in hypertensive patients with cardiovascular disease. Objective: We sought to investigate correlation between short-term BPV and cardiovascular outcomes in the hypertensive population with cardiovascular disease. Methods: Retrospective cohort study was conducted in NCC Harapan Kita, involving hypertensive patient with cardiovascular disease underwent 24-hours ABPM. Inclusion criteria were hypertensive patient with left ventricular hyperthrophy (LVH), documented coronary artery disease (CAD), pre-existing heart failure and atrial fibrillation. Data of 197 eligible patient were collected from electronic medical record and followed up from the ABPM examination for at least 1 year or until an event occur. The event is defined as a composite of all-cause mortality, acute coronary syndrome, stroke, heart failure requiring hospitalization, or need of coronary revascularization. Result: Out of 197 subjects who met the inclusion criteria, 139 (70.6%) had sustained hypertension. Subset of BPV identified as risers (30.5%), non-dippers (43.1%), dippers (23.9%) and extreme dippers (2%). The morning blood pressure surge (MBPS) was observed in 50.8%. During follow up with median duration of 25 months (1 to 85 months), 32 subjects (16.2%) had cardiovascular outcomes. Multivariate analysis using Cox regression shows that none of the subset of blood pressure variability have significant correlation with cardiovascular outcomes. Conclusion: In this study short-term BPV is not correlated with cardiovascular outcomes at 1 year follow up. The result suggested that in hypertensive patient with CV disease, the time to secondary events may need longer period.