Visit-to-Visit Blood Pressure Variability, Carotid Atherosclerosis, and Cardiovascular Events in the European Lacidipine Study on Atherosclerosis
Key result
Visit-to-visit blood pressure variability was not associated with carotid intima-media thickness or cardiovascular outcomes, whereas mean SBP was (P for trend=0.046 and 0.048).
Why the study?
Is visit-to-visit blood pressure variability associated with carotid intima-media thickness progression and cardiovascular outcomes in treated mildly to moderately hypertensive patients?
Population
1,521 treated mildly to moderately hypertensive patients from the European Lacidipine Study on Atherosclerosis
Comparison
Visit-to-visit blood pressure variability vs Mean on-treatment SBP
Design
Cohort, randomized (original trial), double-blind (original trial)
Follow-up
4 years
Authors
Discussion
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Implication
Mean SBP, not variability, should guide risk assessment in treated hypertension; this cohort analysis leaves open whether variability reduction improves outcomes.
Study Design
Type
RCT (n=1,521)
Blinding
Double-blind
Randomization
Randomized
Multicenter
Yes
Structured PICO
Is visit-to-visit blood pressure variability associated with carotid intima-media thickness progression and cardiovascular outcomes in treated mildly to moderately hypertensive patients?
P
Population
1,521 treated mildly to moderately hypertensive patients from the European Lacidipine Study on Atherosclerosis (ELSA)
I
Intervention
Visit-to-visit blood pressure variability (assessed by coefficient of variation or SD of mean on-treatment SBP)
C
Comparator
Mean on-treatment SBP
O
Outcome
End-of-treatment echographic carotid intima-media thickness and cardiovascular outcomessurrogate
In mildly to moderately hypertensive patients, long-term average BP levels are more prognostically important for carotid atherosclerosis progression and cardiovascular events than visit-to-visit BP variability.
Cite This Study
Mancia et al. (2012) conducted an RCT in Mild to moderate hypertension (n=1,521). Lacidipine vs. Atenolol was evaluated on End-of-treatment carotid intima-media thickness and cardiovascular outcomes. Visit-to-visit blood pressure variability was not associated with carotid intima-media thickness or cardiovascular outcomes, whereas mean SBP was (P for trend=0.046 and 0.048).