The highest quartile of within-visit blood pressure changes was associated with an increased risk of all-cause mortality compared to the lowest quartile (HR 1.070; 95% CI 1.041-1.100).
Cohort
Do higher within-visit blood pressure changes increase the risk of all-cause mortality and cardiovascular events in individuals without a history of hypertension?
Within-visit blood pressure changes are independently associated with increased risks of mortality, new-onset hypertension, and major adverse cardiovascular events in individuals without prior hypertension.
Effect estimate: HR 1.070 (95% CI 1.041-1.100)
BACKGROUND: Beyond average blood pressure (BP) levels, short-term BP fluctuations may carry important prognostic information. However, the clinical significance of within-visit BP changes remains limited. This study aimed to evaluate the association between within-visit BP changes and clinical outcomes. METHODS: We analyzed data from the UK Biobank. BP was measured twice, with at least 1 minute between measurements, while participants were seated. Within-visit BP changes were defined as the absolute difference between 2 consecutive systolic BP measurements, and participants were categorized into within-visit BP changes quartiles. The primary outcome was all-cause mortality, and secondary outcomes included new-onset hypertension and major adverse cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, and heart failure). Multivariable Cox proportional hazards models, adjusted for demographics, cardiovascular risk factors, comorbidities, and baseline BP, were used to estimate hazard ratios (HRs). RESULTS: Higher within-visit BP changes were associated with elevated systolic and diastolic BP and a higher incidence of hypertension. All-cause mortality and major adverse cardiovascular events increased progressively across BP changes quartiles, and these results remained consistent in fully adjusted models. Compared with the lowest quartile, the highest quartile showed an elevated risk of all-cause mortality (HR, 1.070 95% CI, 1.041-1.100), nonfatal myocardial infarction (HR,1.070 95% CI, 1.021-1.121), stroke (HR,1.086 95% CI, 1.027-1.148), and heart failure (HR,1.069 95% CI, 1.015-1.127). BP changes as a continuous variable demonstrated a significant linear association without evidence of nonlinearity. CONCLUSIONS: Within-visit BP changes are independently associated with the development of hypertension, mortality, and major adverse cardiovascular events, supporting its potential role as a marker of long-term cardiovascular risk.
Jin et al. (Tue,) conducted a cohort in Without a history of hypertension. Higher within-visit blood pressure changes vs. Lowest quartile of within-visit BP changes was evaluated on All-cause mortality (HR 1.070, 95% CI 1.041-1.100). The highest quartile of within-visit blood pressure changes was associated with an increased risk of all-cause mortality compared to the lowest quartile (HR 1.070; 95% CI 1.041-1.100).
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