Visit-to-visit Variability of Blood Pressure is Associated with Hospitalization and Mortality in an Unselected Adult Population

Visit-to-visit Variability of Blood Pressure is Associated with Hospitalization and Mortality in... 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: journals.permissions@oup.com 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) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Hypertension Oxford University Press

Visit-to-visit Variability of Blood Pressure is Associated with Hospitalization and Mortality in an Unselected Adult Population

Loading next page...
 
/lp/ou_press/visit-to-visit-variability-of-blood-pressure-is-associated-with-K9pfecCMjg
Publisher
Oxford University Press
Copyright
© American Journal of Hypertension, Ltd 2018. All rights reserved. For Permissions, please email: journals.permissions@oup.com
ISSN
0895-7061
eISSN
1941-7225
D.O.I.
10.1093/ajh/hpy088
Publisher site
See Article on Publisher Site

Abstract

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: journals.permissions@oup.com 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)

Journal

American Journal of HypertensionOxford University Press

Published: May 31, 2018

There are no references for this article.

You’re reading a free preview. Subscribe to read the entire article.


DeepDyve is your
personal research library

It’s your single place to instantly
discover and read the research
that matters to you.

Enjoy affordable access to
over 18 million articles from more than
15,000 peer-reviewed journals.

All for just $49/month

Explore the DeepDyve Library

Search

Query the DeepDyve database, plus search all of PubMed and Google Scholar seamlessly

Organize

Save any article or search result from DeepDyve, PubMed, and Google Scholar... all in one place.

Access

Get unlimited, online access to over 18 million full-text articles from more than 15,000 scientific journals.

Your journals are on DeepDyve

Read from thousands of the leading scholarly journals from SpringerNature, Elsevier, Wiley-Blackwell, Oxford University Press and more.

All the latest content is available, no embargo periods.

See the journals in your area

DeepDyve

Freelancer

DeepDyve

Pro

Price

FREE

$49/month
$360/year

Save searches from
Google Scholar,
PubMed

Create lists to
organize your research

Export lists, citations

Read DeepDyve articles

Abstract access only

Unlimited access to over
18 million full-text articles

Print

20 pages / month

PDF Discount

20% off