Key result
24-hour systolic BP shows ~20% lower variability than office BP across visits.
Why the study?
While visit-to-visit office blood pressure variability carries an adverse prognostic impact in treated hypertensive patients, little information is available on visit-to-visit 24-h blood pressure variability.
Does 24-h blood pressure variability differ from visit-to-visit office blood pressure variability in treated hypertensive patients?
Observational (n=1,114)
Does 24-h blood pressure variability differ from visit-to-visit office blood pressure variability in treated hypertensive patients?
24-hour mean blood pressure across visits is more stable than office BP, and office BP variations are poorly predictive of 24-hour ambulatory BP stability.
Answers are grounded in this paper and cite their sources.
Office BP variability overestimates 24-h stability; leaves open whether ambulatory monitoring improves variability-based risk prediction in hypertension.
OBJECTIVES: In any treated hypertensive patient office blood pressure (BP) values may differ between visits and this variability (V) has an adverse prognostic impact. However, little information is available on visit-to-visit 24-h BPV. METHODS: In 1114 hypertensives of the ELSA and PHYLLIS trials we compared visit-to-visit office and 24-h mean BPV by coefficient of variation (CV) of the mean systolic (S) and diastolic (D) BP obtained from yearly measurements during a 3-4 year treatment period. Visit-to-visit BPV during daytime and night-time were also compared. RESULTS: Twenty-four-hour SBP-CV was about 20% less than office SBP-CV ( P < 0.0001). SBP-CV was considerably greater for the night-time than for the daytime period (20%, P < 0.0001). Results were similar for DBP and in males and females, older and younger patients, patients under different antihypertensive drugs or with different baseline or achieved BP values. In the group as a whole and in subgroups there was significant correlations between office and 24-h BP-CV but the correlation coefficients was weak, indicating that office SBP or DBP CV accounted for only about 1-4% of 24-h SBP or DBP-CV values. CONCLUSION: Twenty-four-hour mean BP across visits is more stable than across visit office BP. Visit-to-visit office and 24-h BPV are significantly related to each other, but correlation coefficients are low, making visit-to-visit office BP variations poorly predictive of the concomitant 24-h BP variations and thus of on-treatment ambulatory BP stability.
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Mancia et al. (2023) conducted an observational in Hypertension (n=1,114). 24-h blood pressure variability vs. Visit-to-visit office blood pressure variability was evaluated on Coefficient of variation (CV) of the mean systolic and diastolic blood pressure (p=< 0.0001). Twenty-four-hour systolic blood pressure coefficient of variation was about 20% less than office systolic blood pressure coefficient of variation across visits.
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