Document Detail


Association between annual visit-to-visit blood pressure variability and stroke in postmenopausal women: data from the Women's Health Initiative.
MedLine Citation:
PMID:  22753206     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Accumulating evidence suggests that increased visit-to-visit variability (VVV) of blood pressure is associated with stroke. No study has examined the association between VVV of blood pressure and stroke in postmenopausal women, and scarce data exist as to whether this relation is independent of the temporal trend of blood pressure. We examined the association of VVV of blood pressure with stroke in 58,228 postmenopausal women enrolled in the Women's Health Initiative. Duplicate blood pressure readings, which were averaged, were taken at baseline and at each annual visit. VVV was defined as the SD for the participant's mean systolic blood pressure (SBP) across visits (SD) and about the participant's regression line with SBP regressed across visits (SDreg). Over a median follow-up of 5.4 years, 997 strokes occurred. In an adjusted model including mean SBP over time, the hazard ratios (95% CI) of stroke for higher quartiles of SD of SBP compared with the lowest quartile (referent) were 1.39 (1.03-1.89) for quartile 2, 1.52 (1.13-2.03) for quartile 3, and 1.72 (1.28-2.32) for quartile 4 (P trend <0.001). The relation was similar for SDreg of SBP quartiles in a model that additionally adjusted for the temporal trend in SBP (P trend <0.001). The associations did not differ by stroke type (ischemic versus hemorrhagic). There was a significant interaction between mean SBP and SDreg on stroke with the strongest association seen below 120 mmHg. In postmenopausal women, greater VVV of SBP was associated with increased risk of stroke, particularly in the lowest range of mean SBP.
Authors:
Daichi Shimbo; Jonathan D Newman; Aaron K Aragaki; Michael J LaMonte; Anthony A Bavry; Matthew Allison; JoAnn E Manson; Sylvia Wassertheil-Smoller
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.     Date:  2012-07-02
Journal Detail:
Title:  Hypertension     Volume:  60     ISSN:  1524-4563     ISO Abbreviation:  Hypertension     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-08-16     Completed Date:  2013-01-07     Revised Date:  2013-09-03    
Medline Journal Info:
Nlm Unique ID:  7906255     Medline TA:  Hypertension     Country:  United States    
Other Details:
Languages:  eng     Pagination:  625-30     Citation Subset:  IM    
Affiliation:
Columbia University Medical Center, 622 West 168th St, PH 9-310, New York, NY 10032, USA. ds2231@columbia.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure / physiology*
Cohort Studies
Female
Follow-Up Studies
Heart Rate / physiology
Humans
Hypertension / complications*,  physiopathology*
Incidence
Longitudinal Studies
Middle Aged
Office Visits*
Postmenopause / physiology*
Risk Factors
Stroke / epidemiology*
Systole / physiology
Women's Health
Grant Support
ID/Acronym/Agency:
N01 WH32115/WH/WHI NIH HHS; N01WH22110/WH/WHI NIH HHS; N01WH22110/WH/WHI NIH HHS; N01WH24152/WH/WHI NIH HHS; N01WH24152/WH/WHI NIH HHS; N01WH32100/WH/WHI NIH HHS; N01WH32100-2/WH/WHI NIH HHS; N01WH32101/WH/WHI NIH HHS; N01WH32102/WH/WHI NIH HHS; N01WH32105/WH/WHI NIH HHS; N01WH32105-6/WH/WHI NIH HHS; N01WH32106/WH/WHI NIH HHS; N01WH32108/WH/WHI NIH HHS; N01WH32108-9/WH/WHI NIH HHS; N01WH32109/WH/WHI NIH HHS; N01WH32111/WH/WHI NIH HHS; N01WH32111-13/WH/WHI NIH HHS; N01WH32112/WH/WHI NIH HHS; N01WH32113/WH/WHI NIH HHS; N01WH32115/WH/WHI NIH HHS; N01WH32118/WH/WHI NIH HHS; N01WH32118-32119/WH/WHI NIH HHS; N01WH32119/WH/WHI NIH HHS; N01WH32122/WH/WHI NIH HHS; N01WH32122/WH/WHI NIH HHS; N01WH42107/WH/WHI NIH HHS; N01WH42107-26/WH/WHI NIH HHS; N01WH42129/WH/WHI NIH HHS; N01WH42129-32/WH/WHI NIH HHS; N01WH42130/WH/WHI NIH HHS; N01WH42131/WH/WHI NIH HHS; N01WH42132/WH/WHI NIH HHS; N01WH44221/WH/WHI NIH HHS; N01WH44221/WH/WHI NIH HHS; UL1 TR000064/TR/NCATS NIH HHS
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