title: Visit-to-visit blood pressure variability and cardiovascular death in the Systolic Hypertension in the Elderly Program.
abstract: Most studies of an association of visit-to-visit variability of blood pressure with increased risk of future adverse cardiovascular events are of short duration and rarely include a placebo group. Using data from the double-blind, placebo-controlled Systolic Hypertension in the Elderly Program, the authors examined mortality from cardiovascular causes up to 17 years of follow-up using the National Death Index. Visit-to-visit blood pressure variability was associated with cardiovascular death after adjustment for sex, age, serum creatinine, diabetes, body mass index, smoking status, left ventricular failure, and high-density lipoprotein cholesterol. The relationship was significantly stronger in the active treatment group compared with the placebo group. Although this could be the result of an effect of the medications used unrelated to visit-to-visit variability, the data are compatible with the hypothesis that inconsistent adherence leading to missing active medication doses may be an additional explanation for the relationship of visit-to-visit variability with cardiovascular death.
authors: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ.
authors: John B
authors: JB
authors: Kostis
authors: Jeanine E
authors: JE
authors: Sedjro
authors: Javier
authors: J
authors: Cabrera
authors: Nora M
authors: NM
authors: Cosgrove
authors: John S
authors: JS
authors: Pantazopoulos
authors: William J
authors: WJ
authors: Kostis
authors: Sara L
authors: SL
authors: Pressel
authors: Barry R
authors: BR
authors: Davis
mesh_terms: D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001262:Atenolol / Q000494:pharmacology / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality*; D002752:Chlorthalidone / Q000494:pharmacology / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D009819:Office Visits / Q000706:statistics & numerical data*; D010349:Patient Compliance; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D001262:Atenolol; D002752:Chlorthalidone