Key result
The highest tertile of 24-hour systolic blood pressure variability was significantly associated with increased in-hospital mortality compared to the lowest tertile (OR 3.333; 95% CI 1.725-6.439).
Why the study?
Findings regarding the association between the coefficient of variation of 24-h blood pressure and mortality in acute myocardial infarction patients remain inconsistent.
Does high 24-h blood pressure variability increase the risk of all-cause mortality in patients with acute myocardial infarction?
Cohort (n=1,291)
Does high 24-h blood pressure variability increase the risk of all-cause mortality in patients with acute myocardial infarction?
Odds Ratio: 3.333 (95% CI 1.725–6.439)
High 24-hour systolic and diastolic blood pressure variability is a significant prognostic marker for increased short- and long-term all-cause mortality in patients with acute myocardial infarction.
May flag higher short-term mortality risk in AMI; leaves open whether BPV is modifiable target or marker.
Background Blood pressure variability (BPV) is recognized as an independent risk factor for cardiovascular morbidity and mortality. However, findings regarding the association between the coefficient of variation (CV) of 24‐h blood pressure and mortality in patients with acute myocardial infarction (AMI) remain inconsistent. The aim of this study was to examine the association between 24‐h CV and the risk of in‐hospital, 30‐day, 1‐year, and 3‐year mortality in AMI patients. Methods This retrospective cohort study included AMI patients who were admitted to the intensive care unit (ICU) from the MIMIC‐IV 2.0 database. The CV was calculated from blood pressure measurements taken during the first 24 h. Patients were divided into three groups according to tertiles of 24‐h blood pressure CV. The relationship between 24‐h CV and the risk of all‐cause mortality in AMI patients was analyzed using logistic regression, Cox proportional hazards regression, and Kaplan–Meier survival analyses. Results A total of 1291 eligible AMI patients were included. Compared with Q1 (lowest CV), Q3 (highest 24‐h systolic blood pressure [SBP]‐CV) was significantly associated with an increased risk of in‐hospital (odds ratio [OR]: 3.333, 95% confidence interval [CI]: 1.725–6.439), 30‐day (hazard ratio [HR]: 1.868, 95% CI: 1.201–2.904), and 1‐year (HR: 1.420, 95% CI: 1.058–1.907) mortality. Both Q2 and Q3 of 24‐h diastolic blood pressure (DBP)–CV were significantly associated with an increased risk of in‐hospital, 30‐day, 1‐year, and 3‐year mortality. Kaplan–Meier survival curves demonstrated that patients in Q3 had significantly lower 30‐day, 1‐year, and 3‐year survival probabilities than those in other tertiles for both SBP and DBP. Conclusions Our findings suggest that 24‐h SBP‐CV and DBP‐CV are significantly associated with both short‐ and long‐term outcomes in AMI patients. BPV may serve as a prognostic marker for all‐cause mortality in AMI patients.
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Liu et al. (2026) conducted a cohort in Acute myocardial infarction (AMI) (n=1,291). High 24-h systolic blood pressure variability (highest tertile of CV) vs. Low 24-h systolic blood pressure variability (lowest tertile of CV) was evaluated on In-hospital mortality (OR 3.333, 95% CI 1.725-6.439). The highest tertile of 24-hour systolic blood pressure variability was significantly associated with increased in-hospital mortality compared to the lowest tertile (OR 3.333; 95% CI 1.725-6.439).
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