Key result
High systolic BPV in adults ≥65 is linked to ~33% higher odds of cardiovascular disease and cerebral deterioration.
Why the study?
The clinical relevance of blood pressure variability (BPV) remains unknown, and gold standards and normal reference values to define high BPV are lacking.
Does high blood pressure variability predict negative health outcomes in adults aged ≥65?
Meta-Analysis
Does high blood pressure variability predict negative health outcomes in adults aged ≥65?
Odds Ratio: 1.33 (95% CI 1.19–1.48)
p-value: p=<.00001
Elevated systolic blood pressure variability is a significant predictor of cardiovascular disease and cerebral deterioration in older adults, with higher predictive odds than mean blood pressure.
May refine CVD risk assessment in older adults; leaves open whether BPV modification alters outcomes.
BACKGROUND: The clinical relevance of blood pressure variability (BPV) is still unknown, despite increasing evidence associating BPV to negative health outcomes (NHOs). There is currently no gold standard to define high BPV and normal reference values for BPV are lacking. AIM: The primary aim was to examine whether high BPV can predict NHO in adults aged ≥65. The predictive value of BPV was compared to mean BP (mBP) when both parameters were available. METHODS: PubMed and Web of Science were systematically screened; 49 articles (12 retrospective, 18 prospective and 19 cross-sectional studies) were included and evaluated for methodological quality. Meta-analyses were conducted to examine the association of BPV (and mBP when available) with NHO. RESULTS: Systolic BPV and systolic mBP seem to indicate at least comparable odds for cardiovascular disease (BPV: odds ratio (OR) = 1.33 (95% CI: 1.19-1.48, P < .00001) vs mBP: OR = 1.06 (95% CI: 1.03-1.09, P = .0002)) and cerebral deterioration (BPV: OR = 1.28 (95% CI: 1.17-1.41, P < .00001) vs mBP: OR = 1.06 (95% CI: 1.04-1.09, P < .00001)). Increased diastolic BPV was associated with higher odds of cerebral deterioration (OR = 1.18 (95% CI: 1.04-1.35), P = .01). CONCLUSION: High systolic BPV and high systolic mBP are associated with 33% and 6% higher odds of cardiovascular disease in adults aged ≥65, respectively. High BPV is also related to an 18%-28% and 11% increased odds of cerebral deterioration and poor stroke recovery. An overview of cut-off values is provided for the most often reported BPV parameters in literature, which can be used as a guideline to identify elevated BPV in clinical practice.
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Saren et al. (2024) conducted a meta-analysis in Negative health outcomes (cardiovascular disease, cerebral deterioration). High blood pressure variability (BPV) vs. Mean blood pressure (mBP) was evaluated on Cardiovascular disease (OR 1.33, 95% CI 1.19-1.48, p=<.00001). High systolic blood pressure variability in adults aged ≥65 is associated with increased odds of cardiovascular disease (OR 1.33; 95% CI 1.19-1.48; P<.00001) and cerebral deterioration.
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