Abstract FR540: Sex Disparity for the Association Between Within-Visit Systolic Blood Pressure Variability and Hypertension

Background: Blood pressure variability (BPV) including within-visit BPV (VBPV) is associated with unfavorable cardiovascular outcomes. However, the association between VBPV and hypertension (HTN) remains unclear. This study aims to investigate the association between VBPV, and hypertension across different age groups and sexes. Methods: A retrospective cross-sectional analysis using data from the 2017–2020 NHANES included participants with 1–3 BP readings on one visit. VBPV defined by average real variability of systolic and diastolic blood pressure (SBP-ARV and DBP-ARV) from 3 BP readings were categorized into quartiles (Q). The associations of SBP-ARV and DBP-ARV with HTN were analyzed using multiple logistic regression, adjusting for demographics, comorbidities, laboratory values, average sodium intake, and socioeconomic status. Result: Of 5,290 adults, 37.54% reported having HTN. The mean age±SD was 50±17 years, and the mean SBP and DBP were 124±19 and 75±11 mmHg, respectively. The median [IQR] of SBP-ARV was 3.5 [2-6], and DBP-ARV was 2.5 [1.5-4]. In the fully adjusted model, there was an inverse association between SBP-ARV quartiles and odds of HTN in Q2 and Q3 (aOR Q2 1.62 (1.08-2.43), P 0.02, aOR Q3 1.54 (1.02-2.33), P 0.04, aOR Q4 1.59 (0.99-2.53), P 0.053). However, in Q4, a significant association with HTN was observed in women but not in men (aOR SBP-ARV-Q4+Female 1.44 (1.10-1.87), P 0.01). There was no DBP-ARV – HTN association. The older age group, 65-75 years old, was an effect modifier for lower odds of HTN observed across all SBP-ARV quartiles (aOR SBP-ARV-Q2+Age 0.40 (0.21-0.77), P 0.01, aOR SBP-ARV-Q3+Age 0.50 (0.26-0.95), P 0.04, aOR SBP-ARV-Q4+Age 0.48 (0.24-0.95), P 0.04). Conclusions: Higher systolic VBPV is associated with the likelihood of HTN, particularly in younger women. Systolic VBPV may serve as a marker for individuals at risk for HTN.