Document Detail

The association of a simple blood pressure-independent parameter derived from ambulatory blood pressure variability with short-term mortality.
MedLine Citation:
PMID:  19390534     Owner:  NLM     Status:  MEDLINE    
We explored the predictive ability of the blood pressure variability ratio (BPVR), defined as the ratio of 24-h ambulatory systolic blood pressure variability to diastolic variability, and evaluated its predictable relation with blood pressure and the Ambulatory Arterial Stiffness Index (AASI). A total of 3433 consecutive patients were followed up to 16 years for all-cause mortality. Blood pressure variability was expressed by the standard deviation. BPVR, which is the systolic-on-diastolic slope estimated by a known type of symmetric regression ('reduced major axis'), was compared with other expressions of this slope and with AASI using other regression procedures. Time-dependent Cox proportional hazard models, adjusted for demographics, 24-h mean blood pressure, 24-h pulse pressure and dipping were used to assess the association of BPVR and slope-related parameters with all-cause mortality. We found that Pearson's correlation between BPVR and the symmetric slope was 0.957, and between 1-1/BPVR (an AASI-equivalent expression) and the symmetric version of AASI was 0.973. BPVR was entirely independent of mean arterial pressure (r=0.013). Systolic and diastolic ambulatory blood pressure variability was not significantly associated with mortality. Over 16 years, BPVR predicted all-cause mortality [hazard ratio=1.21 (95% CI 1.05-1.40) per 1 s.d. increase]. In time-dependent models, increased BPVR was strongly associated with an 18-month mortality, weakly related to 7 years mortality, showing no effect thereafter. Thus, the ratio between 24-h systolic and diastolic blood pressure variability, readily available from ambulatory monitoring reports, is an easy-to-calculate systolic-on-diastolic slope. It is a blood pressure-independent measure believed to express an arterial property, with prognostic power similar to that of AASI.
Benjamin Gavish; Iddo Z Ben-Dov; Jeremy D Kark; Judith Mekler; Michael Bursztyn
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Publication Detail:
Type:  Journal Article     Date:  2009-04-24
Journal Detail:
Title:  Hypertension research : official journal of the Japanese Society of Hypertension     Volume:  32     ISSN:  1348-4214     ISO Abbreviation:  Hypertens. Res.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-04     Completed Date:  2009-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9307690     Medline TA:  Hypertens Res     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  488-95     Citation Subset:  IM    
InterCure Ltd, Lod, Israel.
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MeSH Terms
Arteries / physiopathology
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory*
Body Mass Index
Databases, Factual
Hypertension / mortality*,  physiopathology*
Middle Aged
Predictive Value of Tests
Proportional Hazards Models
Regression Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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