Abstract Background Blood pressure variability has been associated with poor health outcomes in high-risk patients, but its association in more general populations is poorly understood. Methods We analyzed outcomes from 240,622 otherwise unselected patients who had 10 or more outpatient blood pressure readings recorded over a three-year period and were ages 20 to 100 years. Results Whether calculated as SD, average change, or greatest change and systolic or diastolic blood pressure, we found that higher outpatient blood pressure variability was associated with subsequent hospitalization and mortality. Systolic pressure average change exceeding 10-12 mmHg or diastolic exceeding 8 mmHg significantly increased risk of hospitalization and death (odds ratios from 2.0 to 4.5). Variability in the highest decile increased risks even more dramatically, with propensity-matched odds ratios from 4.4 to 42. A systolic change exceeding 35 mmHg increased the relative risk of death 4.5-fold. Similarly, a diastolic change greater than 23-24 mmHg almost tripled the risks of hospitalization and death. Neither stratification for hypertension nor propensity matching for risk factors within the database affected these associations. Conclusions Systolic and diastolic variability were each associated with subsequent adverse outcomes. Physicians should pay special attention to patients with swings in blood pressure between clinic visits. Electronic medical records should flag such variability. variability, variance, blood pressure, hospitalization, mortality © American Journal of Hypertension, Ltd 2018. All rights reserved. For Permissions, please email: firstname.lastname@example.org This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/about_us/legal/notices)
American Journal of Hypertension – Oxford University Press
Published: May 31, 2018
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