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Article: Association of visit-to-visit variability of systolic blood pressure with cardiovascular disease, chronic kidney disease and mortality in patients with hypertension
Title | Association of visit-to-visit variability of systolic blood pressure with cardiovascular disease, chronic kidney disease and mortality in patients with hypertension |
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Authors | |
Keywords | blood pressure cardiovascular disease chronic kidney disease hypertension mortality |
Issue Date | 2020 |
Publisher | Lippincott Williams & Wilkins, Ltd. The Journal's web site is located at http://www.jhypertension.com/ |
Citation | Journal of Hypertension, 2020, v. 38 n. 5, p. 943-953 How to Cite? |
Abstract | Objective:
This study aimed to evaluate the association between visit-to-visit variability of systolic blood pressure (SBP) and cardiovascular disease, chronic kidney disease, and mortality among hypertensive patients.
Methods:
A population-based cohort included 225 759 Chinese hypertensive adults without diabetes, cardiovascular disease, and chronic kidney disease during 2011–2012. SBP variability was determined based on standard deviations of SBP over the previous 5 years before baseline. Cox regressions adjusted with patients’ baseline characteristics, mean, and temporal trend of SBP was applied to the associations between variability and incident cardiovascular disease, chronic kidney disease and all-cause mortality.
Results:
In all, 25 714 patients with cardiovascular disease, 27 603 with chronic kidney disease, and 16 778 deaths have occurred during the median follow-up of 70.5 months (1.2 million person-years). SBP variability was continuously and positively associated with higher cardiovascular disease, chronic kidney disease and mortality risk among hypertensive patients without evidence of a threshold. Each 10-mmHg increase in SD of SBP was associated with 35% [hazard ratio 1.35, 95% confidence interval (CI) 1.30–1.39], 39% (HR 1.39, 95% CI 1.35–1.43), and 40% (HR 1.40, 95% CI 1.34–1.45) higher risk of cardiovascular disease, chronic kidney disease and mortality, respectively. HRs were attenuated with increased age, mean SBP, and Charlson index, and decreased temporal trend of systolic blood pressure, but it remained significant and consistent in most of the different subgroups.
Conclusions:
Findings suggested that SBP variability is a significant prognostic value, in addition to baseline or mean of SBP for the risk of cardiovascular disease and mortality. |
Persistent Identifier | http://hdl.handle.net/10722/280944 |
ISSN | 2023 Impact Factor: 3.3 2023 SCImago Journal Rankings: 1.134 |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Wan, EYF | - |
dc.contributor.author | Yu, EYT | - |
dc.contributor.author | Chin, WY | - |
dc.contributor.author | Fong, DYT | - |
dc.contributor.author | Choi, EPH | - |
dc.contributor.author | Lam, CLK | - |
dc.date.accessioned | 2020-02-25T07:43:04Z | - |
dc.date.available | 2020-02-25T07:43:04Z | - |
dc.date.issued | 2020 | - |
dc.identifier.citation | Journal of Hypertension, 2020, v. 38 n. 5, p. 943-953 | - |
dc.identifier.issn | 0263-6352 | - |
dc.identifier.uri | http://hdl.handle.net/10722/280944 | - |
dc.description.abstract | Objective: This study aimed to evaluate the association between visit-to-visit variability of systolic blood pressure (SBP) and cardiovascular disease, chronic kidney disease, and mortality among hypertensive patients. Methods: A population-based cohort included 225 759 Chinese hypertensive adults without diabetes, cardiovascular disease, and chronic kidney disease during 2011–2012. SBP variability was determined based on standard deviations of SBP over the previous 5 years before baseline. Cox regressions adjusted with patients’ baseline characteristics, mean, and temporal trend of SBP was applied to the associations between variability and incident cardiovascular disease, chronic kidney disease and all-cause mortality. Results: In all, 25 714 patients with cardiovascular disease, 27 603 with chronic kidney disease, and 16 778 deaths have occurred during the median follow-up of 70.5 months (1.2 million person-years). SBP variability was continuously and positively associated with higher cardiovascular disease, chronic kidney disease and mortality risk among hypertensive patients without evidence of a threshold. Each 10-mmHg increase in SD of SBP was associated with 35% [hazard ratio 1.35, 95% confidence interval (CI) 1.30–1.39], 39% (HR 1.39, 95% CI 1.35–1.43), and 40% (HR 1.40, 95% CI 1.34–1.45) higher risk of cardiovascular disease, chronic kidney disease and mortality, respectively. HRs were attenuated with increased age, mean SBP, and Charlson index, and decreased temporal trend of systolic blood pressure, but it remained significant and consistent in most of the different subgroups. Conclusions: Findings suggested that SBP variability is a significant prognostic value, in addition to baseline or mean of SBP for the risk of cardiovascular disease and mortality. | - |
dc.language | eng | - |
dc.publisher | Lippincott Williams & Wilkins, Ltd. The Journal's web site is located at http://www.jhypertension.com/ | - |
dc.relation.ispartof | Journal of Hypertension | - |
dc.rights | This is a non-final version of an article published in final form in (provide complete journal citation) | - |
dc.subject | blood pressure | - |
dc.subject | cardiovascular disease | - |
dc.subject | chronic kidney disease | - |
dc.subject | hypertension | - |
dc.subject | mortality | - |
dc.title | Association of visit-to-visit variability of systolic blood pressure with cardiovascular disease, chronic kidney disease and mortality in patients with hypertension | - |
dc.type | Article | - |
dc.identifier.email | Wan, EYF: yfwan@hku.hk | - |
dc.identifier.email | Yu, EYT: ytyu@hku.hk | - |
dc.identifier.email | Chin, WY: chinwy@hku.hk | - |
dc.identifier.email | Fong, DYT: dytfong@hku.hk | - |
dc.identifier.email | Choi, EPH: ephchoi@hku.hk | - |
dc.identifier.email | Lam, CLK: clklam@hku.hk | - |
dc.identifier.authority | Wan, EYF=rp02518 | - |
dc.identifier.authority | Yu, EYT=rp01693 | - |
dc.identifier.authority | Chin, WY=rp00290 | - |
dc.identifier.authority | Fong, DYT=rp00253 | - |
dc.identifier.authority | Choi, EPH=rp02329 | - |
dc.identifier.authority | Lam, CLK=rp00350 | - |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1097/HJH.0000000000002347 | - |
dc.identifier.scopus | eid_2-s2.0-85082780196 | - |
dc.identifier.hkuros | 309182 | - |
dc.identifier.volume | 38 | - |
dc.identifier.issue | 5 | - |
dc.identifier.spage | 943 | - |
dc.identifier.epage | 953 | - |
dc.identifier.isi | WOS:000555425200019 | - |
dc.publisher.place | United Kingdom | - |
dc.identifier.issnl | 0263-6352 | - |