title: Within-visit BP variability, cardiovascular risk factors, and BP control in central and eastern Europe: findings from the BP-CARE study.
abstract: OBJECTIVE
  Blood pressure variability (BPV) within 24 h or between visits has been found to represent an independent risk factor for cardiovascular disease. The present study was aimed at determining whether a clinical significance can be given also to the BP variations occurring within a single clinical visit.
  
  
  METHODS
  BPV was quantified as coefficient of variation and as standard deviation (SD) of the mean of three systolic SBP values within a visit in the context of a large-cross subclinical survey (BP-CARE) of treated hypertensive patients living in Eastern European countries. The study population was divided into coefficient of variation and SD quartiles and for each quartile a relationship was sought with a large number of cardiovascular risk factors based on patients' history, physical and laboratory examinations.
  
  
  RESULTS
  The 6425 hypertensive patients had an age of 59.2 ± 11 years (mean ± SD); they were equally distributed by sex and displayed an average SD and coefficient of variation amounting to 5.1 ± 6.2 mmHg and 3.5 ± 4.0%, respectively. Compared with the lowest coefficient of variation quartile (Q1), patients in the highest quartile (Q4) showed a significantly greater prevalence of several cardiovascular risk factors, such as age (Q1: 58.5 ± 11 vs. Q4: 60.3 ± 11 years, P < 0.001), serum total cholesterol (Q1: 213.0 ± 46 vs. Q4: 216.4 ± 51 mg/dl, P < 0.05), blood glucose (Q1: 106.2 ± 35 vs. Q4: 109.8 ± 39 mg/dl, P < 0.005), previous cardiovascular events (Q1: 57.4 vs. Q4: 63.9%, P < 0.001), and resistant hypertension (Q1: 26.3 vs. Q4: 34.1%, P < 0.001). They also showed higher office (Q1: 143.2 ± 18 vs. Q4: 154.3 ± 19 mmHg, P < 0.001) and 24-h ambulatory SBP values (Q1: 134.8 ± 17 vs. Q4: 141.2 ± 18 mmHg, P < 0.001). Similar results were obtained when BPV was expressed as SD.
  
  
  CONCLUSIONS
  Our study provides evidence that greater within-visit BP variabilities are associated with a worse cardiovascular risk profile. This suggests that even this type of BPV may have clinical significance.
authors.affiliation: aDipartimento di Scienze della Salute, Clinica Medica, Universita' Milano-Bicocca, Milano bIRCCS Multimedica, Sesto San Giovanni (Milano) cIstituto Auxologico Italiano, Milano, Italy dPharmacology Department and INSERM U970 Hopital Europeen Georges Pompidou, Assistance-Publique Hopitaux de Paris, Paris-Descartes University, Paris, France eInternal Medicine, Hospital Clinico, University of Valencia, CIBERObn, Valencia, Spain.
authors.forename: Guido
authors.initials: G
authors.lastname: Grassi
authors.forename: Gino
authors.initials: G
authors.lastname: Seravalle
authors.forename: Alessandro
authors.initials: A
authors.lastname: Maloberti
authors.forename: Rita
authors.initials: R
authors.lastname: Facchetti
authors.forename: Cesare
authors.initials: C
authors.lastname: Cuspidi
authors.forename: Michele
authors.initials: M
authors.lastname: Bombelli
authors.forename: Stephane
authors.initials: S
authors.lastname: Laurent
authors.forename: Josep
authors.initials: J
authors.lastname: Redon
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D000368:Aged; D001786:Blood Glucose; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000503:physiopathology*; D002784:Cholesterol / Q000097:blood; D005060:Europe; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013599:Systole
chemical_list: D001786:Blood Glucose; D002784:Cholesterol