Blood pressure variability and prognosis in uncomplicated mild hypertension.
BACKGROUND
The independent prognostic value of blood pressure (BP) variability in essential hypertension and particularly in uncomplicated mild hypertension is not yet completely clear. We investigated the relationship between BP variability, evaluated by noninvasive monitoring, and cardiovascular outcome in uncomplicated mild hypertension patients.


METHODS
The occurrence of fatal and nonfatal cardiovascular events was evaluated in 1088 uncomplicated mild hypertension patients, 626 with low BP variability (SD of daytime systolic BP below the mean of the study population) and 462 with high BP variability (SD of daytime systolic BP above the mean of the study population).


RESULTS
During the follow-up (4.74 +/- 2.4 years, range 0.5-9.7 years), the event rates per 100 patient-years in subjects with low and high BP variability were 0.72 and 1.5, respectively. Event-free survival was significantly different between the groups (P = .01). However, after adjustment for other covariates in a Cox multivariate analysis, the adverse prognostic relevance of high BP variability was no longer detectable, whereas age, daytime systolic BP, low-density lipoprotein cholesterol, and smoking habit resulted as independent predictors of cardiovascular events.


CONCLUSIONS
In uncomplicated mild hypertension population, BP variability evaluated by noninvasive monitoring is not an independent predictor of outcome.
Pierdomenico
Sante D
SD
Dipartimento di Medicina e Scienze dell'Invecchiamento, Università Gabriele d'Annunzio, Chieti, Italy. pierdomenico@unich.it
Lapenna
Domenico
D
Bucci
Anna
A
Manente
Bianca M
BM
Mancini
Mariantonietta
M
Cuccurullo
Franco
F
Mezzetti
Andrea
A
D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000209:etiology; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis