BACKGROUND:The prognostic relevance of short-term blood pressure (BP) variability in hypertension is not clearly established. We aimed to evaluate the association of short-term BP variability, with all-cause and cardiovascular mortality in a large cohort of patients with hypertension.METHODS:We selected 59 124 patients from the Spanish Ambulatory Blood Pressure Monitoring Registry from 2004 to 2014 (median follow-up: 9.7 years). Systolic and diastolic BP SD and coefficient of variation from daytime and nighttime, weighted SD, weighted coefficient of variation, average real variability (mean of differences between consecutive readings), and BP variability ratio (ratio between systolic and diastolic 24-hour SD) were calculated through baseline 24-hour ambulatory BP monitoring. Association with all-cause and cardiovascular mortality were assessed by Cox regression models adjusted for clinical confounders and BP.RESULTS:Patients who died during follow-up had higher values of BP variability compared with those remaining alive. In adjusted models systolic and diastolic daytime and weighted SD and coefficient of variation, average real variability, as well as systolic nighttime SD and BP variability ratio were all significantly associated with all-cause and cardiovascular mortality. Hazard ratios for 1-SD increase in the systolic components ranged from 1.05 to 1.12 for all-cause mortality and from 1.07 to 1.17 for cardiovascular mortality. A daytime SD≥13 mm Hg, a nighttime and a weighted SD≥12 mm Hg, and an average real variability ≥10 mm Hg, all systolic, were independently associated with mortality.CONCLUSIONS:Short-term blood pressure variability shows a relatively weak but significant association with all-cause and cardiovascular mortality in patients with hypertension.

中文翻译：

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短期血压变异的预后相关性。西班牙 ABPM 登记处

背景：高血压短期血压（BP）变异与预后的相关性尚未明确。我们的目的是评估一大群高血压患者的短期血压变异性与全因死亡率和心血管死亡率之间的关系。 方法：我们从 2004 年至 2014 年西班牙动态血压监测登记处选择了 59 124 名患者（中位数）随访时间：9.7年）。收缩压和舒张压 SD 以及白天和夜间的变异系数、加权 SD、加权变异系数、平均真实变异性（连续读数之间的差异平均值）以及血压变异率（收缩压和舒张压 24 小时 SD 之间的比率）通过基线 24 小时动态血压监测计算。通过针对临床混杂因素和血压进行调整的 Cox 回归模型来评估与全因死亡率和心血管死亡率的相关性。结果：与仍然存活的患者相比，在随访期间死亡的患者具有更高的血压变异性值。在调整后的模型中，白天收缩压和舒张压、加权 SD 和变异系数、平均真实变异性以及夜间收缩压 SD 和血压变异率均与全因死亡率和心血管死亡率显着相关。收缩期成分 1-SD 增加的全因死亡率的风险比范围为 1.05 至 1.12，心血管死亡率的风险比范围为 1.07 至 1.17。白天 SD ≥ 13 mm Hg，夜间和加权 SD ≥ 12 mm Hg，以及平均实际变异性 ≥ 10 mm Hg（所有收缩压）均与死亡率独立相关。 结论：短期血压变异性相对较弱但与高血压患者的全因死亡率和心血管死亡率显着相关。