Relationship Of Blood Pressure Variability Research Articles

Impact of seasonal blood pressure changes on visit-to-visit blood pressure variability and related cardiovascular outcomes.

Visit-to-visit blood pressure (BP) variability associates with an increased risk of cardiovascular events. We investigated the role of seasonal BP modifications on the magnitude of BP variability and its impact on cardiovascular risk. In 25 390 patients included in the ONTARGET and TRANSCEND trials, the on-treatment systolic (S) BP values obtained by five visits during the first two years of the trials were grouped according to the month in which they were obtained. SBP differences between winter and summer months were calculated for BP variability quintiles (Qs), as quantified by the coefficient of variation (CV) of on-treatment mean SBP from the five visits. The relationship of BP variability with the risk of cardiovascular events and mortality was assessed by the Cox regression model. SBP was approximately 4 mmHg lower in summer than in winter regardless of confounders. Winter/summer SBP differences contributed significantly to each SBP-CV quintile. Increase of SBP-CV from Q1 to Q5 was associated with a progressive increase in the adjusted hazard ratio (HR) of the primary endpoint of the trials, i.e. morbid and fatal cardiovascular events. This association was even stronger after removal of the effect of seasonality from the calculation of SBP-CV. A similar trend was observed for secondary endpoints. Winter/summer SBP differences significantly contribute to visit-to-visit BP variability. However, this contribution does not participate in the adverse prognostic significance of visit-to-visit BP variations, which seems to be more evident after removal of the BP effects of seasonality from visit-to-visit BP variations.

BLOOD PRESSURE VARIABILITY AND MIND COGNITION IMPAIRMENT: A SYSTEMIC REVIEW AND META-ANALYSIS

Objective: Blood pressure variability is hypothesized to play important role in development of cognition impairment. We aimed to explore the relationship of blood pressure variability and cognition impairment. Design and method: We searched the following databases, EMBASE, Cochrane Library, Web of Science, up to October 2021 using blood pressure variability, cognition impairment, cognition dysfunction. Randomized double blind and observational trials were included. Dementia and Alzheimer’s disease cases were excluded. Two reviewers confirmed the inclusion of studies and extracted the data independently. STATA V.15.1 was used to synthesize data. Results: We included 23 studies and enrolled 42964 hypertensive patients. All studies assessed cognition function using Mini-Mental State Examination (MMSE) or other cognition function test. Ambulatory blood pressure variability, visit-to-visit blood pressure variability, measure to measure blood pressure variability, day-to-day blood pressure variability and beat-to-beat systolic blood pressure variability were applied in included trials. The variability of systolic blood pressure has significant relationship with cognition impairment (OR,1.747[1.25,2.44], P < 0.01), however, the variability of diastolic blood pressure did not show relationship with decreasing cognition function scale(OR,0.912[0.81,1.03], P> 0.05) by nalysing data which trial used MMSE scale. Results showed higher systolic blood pressure variability had negative relationship with attention (OR,1.63, [1.28,1.98], P < 0.01). In the aspect of memory and language function, blood pressure variability did not show a significant relationship. Higher blood pressure variability in both systolic and diastolic was associated with lower hippocampal volume and cortical infarcts. Conclusions: The variability of systolic blood pressure is dependently risk factor for cognition impairment in older adults with hypertension. For unsuccessfully treated hypertensive individuals (with blood pressured more than 140/90 mmHg),higher variability in both systolic and diastolic blood pressure was associated with cognitive damage, but these associations were not found in those controlled hypertension older adults.

Роль вариабельности артериального давления при артериальной гипертензии в развитии когнитивных нарушений

Артериальная гипертензия относится к признанным модифицируемым факторам риска поражения головного мозга. На сегодняшний день доказано, что артериальная гипертензия является одной из основных причин развития когнитивных нарушений. В статье показана взаимосвязь вариабельности артериального давления с когнитивными нарушениями согласно данным патофизиологических и клинических исследований. Увеличение показателей вариабельности артериального давления по результатам суточного мониторирования артериального давления способствует возникновению и развитию нарушений когнитивных функций и деменции. Подчеркивается роль вариабельности артериального давления как мишени антигипертензивной терапии.

Lifestyle modification factors in hypertensive patients: impact on blood pressure variability

Current guidelines do not suggest considering blood pressure variability in the management of hypertensive patients. At the same time, a sufficient evidence base has been accumulated on the relationship of blood pressure variability with damage to target organs, the development of stroke, myocardial infarction, cardiovascular mortality, and kidney disease. In general, assessing the effect of blood pressure variability on the course of arterial hypertension, it can be assumed that it is not as significant as the absolute values of blood pressure, but this effect has been proven, regardless of the degree of hypertension. And if a practitioner finds an increased variability in blood pressure in his patient, he should know what recommendations should be given to him.
 Not all traditional lifestyle modification factors that are suggested for hypertensive patients affect blood pressure variability in the same way as blood pressure readings. Thus, we were unable to find evidence of the influence of increased consumption of table salt, physical activity, «chronic psychological stress» on the variability of blood pressure in the general population. At the same time, dietary habits, alcohol abuse, smoking status affect the level of blood pressure, blood pressure variability in both healthy individuals and patients with arterial hypertension. The same effect is exerted by the relative intake of minerals with food, toxic agents (lead). If in individuals of the general population an increase in body weight leads to an increase in blood pressure, then in patients with arterial hypertension such an effect is nonlinear, depending on the type of obesity. It should be emphasized once again that the presence of psychoemotional disorders symptoms of anxiety, depression – in patients with arterial hypertension contributes both to an increase in the level of blood pressure, but also to its variability.

PP.16.14] THE INTERRELATION OF BLOOD PRESSURE VARIABILITY, ENDOTHELIAL FUNCTION AND C-REACTIVE PROTEIN IN PATIENTS WITH ARTERIAL HYPERTENSION AND CORONARY ARTERY DISEASE

Objective: To study the relationship of blood pressure variability (BPV) with parameters of vasomotor endothelial function and C-reactive protein (hsCRP) in patients with arterial hypertension (AH) combined with coronary artery disease (CAD). Design and method: A total of 80 patients with AH degree II-III and CAD were examined. 24-hour monitoring of blood pressure, endothelial dependent vasodilatation (EDV) and endothelium independent vasodilatation (EIV), level of hsCRP were evaluated. Results: In general, in the studied group of patients with BPV the statutory indicators did not exceed, however, the selection of patients with increased BPV showed that they constitute almost half of the observed sample (48.7%). Patients with increased BPV differed from patients with normal BPV by higher values of hsCRP (2.98 ± 0.71 vs 1.56 ± 0.33 mg/l, respectively), body mass index (33.91 ± 1.61 vs 29.49 ± 1.05 kg/m2), less pronounced response to the introduction of nitroglycerin in the evaluation EIV (13.23 ± 1.79 vs 17.70 ± 0.77%, p < 0.05). Correlations identified the relationship between systolic BPV day and EDV (r = −0.44, p = 0.012); hsCRP (r = 0.31, p = 0.008); systolic BPV night and EIV (r = −0.50, p = 0.003); diastolic BPV and EIV (r = −0.43, p = 0.013). The logistic regression analysis revealed that patients with depletion of EIV were 1.2 times more likely to have increased BPV OR 1,223 [95% CI 1,012–1,478; p = 0,037]. In patients with increased systolic BPV higher levels of hsCRP were observed 1.6 times more frequently OR 1.576 [95% CI 1.014–2.451; p = 0.043]. Conclusions: Relation of BPV with indicators of vasomotor endothelial function and a marker of the inflammatory response of the vascular wall that could indicate a pathogenetic relationship of the parameters, which, in turn, determine the development of adverse events in patients with AH and CAD was detected.

Blood pressure variability parameters and the risk of developing hypertension in healthy young males: 5-year follow-up study

Purpose: Few prospective studies have evaluated increase Blood Pressure Variability (BPV) as a risk factor for onset hypertension in young populations. We conducted a prospective cohort study to examine the relationship of BPV to the onset of hypertension in healthy young males depending on family hypertensive anamnesis. Methods: Apparently healthy males aged 18-35 (n=366) without prevalent hypertension at baseline were enrolled in 2003-2005 years. All subjects took an annual medical checkup including Blood Pressure (BP) measurement, Ambulatory 24 hour Blood Pressure Monitoring (ABPM) and veloergometry - at baseline only; medical interview until 2010. The participants were categorized into 2 groups according to family anamnesis of hypertension (1st – positive family anamnesis, 2nd – negative one). Incident hypertension was defined as newly detected BP ≥140/90 mmHg and/or initiation of antihypertensive drugs. The incident hypertension was analyzed in each group. Results: During a median follow-up time of 4.6 years, there were 77 cases (21.0%) of incident hypertension. The incident hypertension rate of the 1st group was significantly higher than of the 2nd group (36.4% vs. 7.3%). The patients of the 1st group with incident hypertension in 5-year follow up had significant increased diastolic BP in veloergometry in comparison with men remained normotension. The range of morning systolic BP surge in ABPM was also higher (38.3±8.9 mmHg vs. 51.1±10.1 mmHg, p=0.039). In the 2nd group significant difference for these parameters was not revealed. The relative risks (RR) (95% confidence interval) adjusted for body mass index, excess salt intake, smoking status, and alcohol intake for incident hypertension in the 1st group in morning systolic BP surge by ABPM ≥50 mmHg was 1.43 (1.29–1.59); in the range diastolic BP in veloergometry >0% – 1.56 (1.29–1.59). Conclusions: Even if BP was within normal range, some parameters of blood pressure variability (systolic blood pressure morning surge in ABPM and elevated diastolic blood pressure in veloergometry) was a predictor of future hypertension in a healthy young-aged male population with positive family hypertensive anamnesis.

The Effect of Baroreflex Function on Blood Pressure Variability

Objective: The aim of this study was to assess the relationship of blood pressure variability (BPV) and heart rate variability (HRV) to investigate the effect of baroreflex function on blood pressure variability. Methods: This study consisted of 111 subjects, including 32 normotensives and 79 hypertensives. All the subjects were given two concurrent tests: 24-hour Holter ECG and ambulatory blood pressure monitoring. According to standard deviation of normal-to-normal sinus RR intervals (SDNN) derived from the Holter ECG, the hypertensives were divided into two groups: an HRV normal group with SDNN > 100 ms and an HRV abnormal group with SDNN

Relationship of Blood Pressure Variability and Heart Rate with Plasma hsCRP in Patients with Recently Diagnosed Hypertension

ëª©ì : 혈압의 변동성과 심장박동수는 í‘œì  장기 손상과 심장 혈관 합병증과 ê´€ë ¨ì´ 있다. 하지만 ê·¸ ì •í™•í•œ ê¸°ì „ì€ ë°í˜€ì ¸ 있지 않다. 이에 ì €ìžë“¤ì€ 혈압의 변동성 및 심장박동수와 염증 인자가 관계가 있는지 í™•ì¸í•˜ê³ ìž 본 연구를 시행하였다. 방법: 최근 진단되거나 새로이 진단된 151ëª ì˜ ê³ í˜ˆì•• 환자의 24시간 활동성 혈압을 분석하였다. 혈압의 변동성은 ì¸¡ì •ëœ 혈압의 표준편차로 표시하였다. 24시간 활동성 혈압 검사 중 동시에 ì¸¡ì •ëœ í‰ê· ì‹¬ìž¥ë°•ë™ìˆ˜ 및 표준편차를 ì¸¡ì •í•˜ì˜€ë‹¤. 혈중 high-sensitivity C-reactive protein (hsCRP)를 염증 인자로 사용하였다. ê²°ê³¼: 대상 환자의 í‰ê· ë‚˜ì´ëŠ” 44 ± 11.3세로 이 중 남자는 74.2%이었다. hsCRP는 남자 환자(0.131 ± 0.014 vs. 0.06 ± 0.023, p= 0.001) 및 í¡ì—°ë ¥ì´ 있는 환자(0.136 ± 0.017 vs. 0.101 ± 0.017, p= 0.003)에서 높게 나타났다. 상관 분석에서 24시간 동안의 이완기 혈압의 변동성은 hsCRP와 양의 상관관계를 보였다(p= 0.002, r = 0.258). 또한 24시간 동안(p= 0.004, r = 0.236), 활동시간 동안(p= 0.003, r = 0.239), 수면시간 동안의 (p= 0.020, r = 0.190) í‰ê· ì‹¬ìž¥ë°•ë™ìˆ˜ ê·¸ë¦¬ê³ 24시간 동안의 심장박동수의 변동성은(p= 0.025, r = 0.182) hsCRP와 양의 상관관계를 보였다. ë‹¤ì¤‘ì„ í˜•íšŒê·€ë¶„ì„ì—ì„œ 24시간 동안의 이완기 혈압의 변동성과(β = 0.286, p= 0.011) 활동시간 동안의 í‰ê· ì‹¬ìž¥ë°•ë™ìˆ˜ê°€(β = 0.169, p= 0.049) hsCRP와 ìœ ì˜í•œ 관계가 있었다. ê²°ë¡ : 24시간 활동성 혈압을 통하여 ì¸¡ì •ëœ 이완기 혈압의 변동성 및 심장박동수는 염증 인자인 hsCRP와 연관성이 있었다. 혈압의 변동성과 심장박동수는 염증반응과 연관하여 심장혈관 합병증에 영향을 주는 것으로 생각한다. 중심 단어: 혈압의 변동성; 심장박동수; C 반응단백; ê³ í˜ˆì••

Short- and Long-Term Blood Pressure Variability

It has long been known that blood pressure (BP) is characterized by an array of spontaneous variations.1 That is, BP values vary markedly within the 24 hours because of day-night changes but also because of differences among hours, minutes, and even adjacent beats. They also show variations over more prolonged periods because of differences among days, months, and seasons,2 also with a trend for systolic BP to increase over the years and for diastolic BP to display an age-related biphasic change.3 This article summarizes current knowledge on short-term (within the 24 hours) and long-term BP variability. Mention will be made of the following: (1) factors responsible for BP variations and mechanisms through which they occur; (2) the relationship of BP variability with BP mean values in absence and during antihypertensive treatment; and (3) the prognostic significance of BP variability. Current limitations of the studies on BP variability will be also discussed to emphasize what future studies should address. ### Factors and Mechanisms A large body of evidence shows that, over the 24 hours, BP undergoes marked variations in response to physical activity, sleep, and emotional stimuli of various nature and duration, thereby documenting the profound involvement of behavioral influences on BP variability. However, spontaneous BP variations also occur independently on behavior. For example, throughout the day and night, BP oscillates regularly at different frequencies, presumably because of influences originating within the brain.4 Furthermore, BP varies more or less regularly in response to the mechanical forces generated by ventilation and also shows irregular nonbehaviorally and nonmechanically related changes with a possible origin from humoral influences and even local vasomotor phenomena. Finally, BP variations are opposed throughout the 24 hours by the baroreflex, which makes the magnitude of 24-hour BP variability in a given individual the net effect of pro-oscillatory and antioscillatory …

220 Relationship of blood pressure variability to left ventricular mass and micro-albuminuria as measures of target-organ damage

220 Relationship of blood pressure variability to left ventricular mass and micro-albuminuria as measures of target-organ damage