Redefined blood pressure variability measure and its association with mortality in elderly primary care patients

Sujuan Gao, Hugh Hendrie, Chenkun Wang, Timothy E. Stump, Jesse C. Stewart, Joe Kesterson, Daniel Clark, Christopher Callahan

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Visit-to-visit blood pressure (BP) variability has received considerable attention recently. The objective of our study is to define a variability measure that is independent of change over time and determine the association between longitudinal summary measures of BP measurements and mortality risk. Data for the study came from a prospective cohort of 2906 adults, aged ≥60 years, in an urban primary care system with ≤15 years of follow-up. Dates of death for deceased participants were retrieved from the National Death Index. Systolic and diastolic BP measurements from outpatient clinic visits were extracted from the Regenstrief Medical Record System. For each patient, the intercept, regression slope, and root mean square error for visit-to-visit variability were derived using linear regression models and used as independent variables in Cox proportional hazards models for both all-cause mortality and mortality attributable to coronary heart disease or stroke. Rate of change was associated with mortality risk in a U-shaped relationship and that participants with little or no change in BP had the lowest mortality risk. BP variability was not an independent predictor of mortality risk. By separating change over time from visit-to-visit variability in studies with relatively long follow-up, we demonstrated in this elderly primary care patient population that BP changes over time, not variability, were associated with greater mortality risk. Future research is needed to confirm our findings in other populations.

Original languageEnglish
Pages (from-to)45-52
Number of pages8
JournalHypertension
Volume64
Issue number1
DOIs
StatePublished - 2014

Fingerprint

Primary Health Care
Blood Pressure
Mortality
Linear Models
Population Dynamics
Ambulatory Care
Ambulatory Care Facilities
Proportional Hazards Models
Hypotension
Medical Records
Coronary Disease
Stroke
Population

Keywords

  • blood pressure
  • cardiovascular diseases
  • cohort studies
  • mortality

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Redefined blood pressure variability measure and its association with mortality in elderly primary care patients. / Gao, Sujuan; Hendrie, Hugh; Wang, Chenkun; Stump, Timothy E.; Stewart, Jesse C.; Kesterson, Joe; Clark, Daniel; Callahan, Christopher.

In: Hypertension, Vol. 64, No. 1, 2014, p. 45-52.

Research output: Contribution to journalArticle

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