Key result
Higher home blood pressure variability was significantly associated with higher pulse pressure (P=0.015) and lower estimated glomerular filtration rate (P=0.049) in patients with treated hypertension.
Why the study?
Blood pressure variability (BPV) is a cardiovascular risk factor regardless of mean blood pressure, prompting investigation into daily home BPV and its association with target organ damage markers in primary care hypertensive patients.
Observational (n=454)
Yes
p-value: p=0.015 for pulse pressure, 0.049 for eGFR
In primary care patients with treated hypertension, greater day-to-day home blood pressure variability is associated with markers of target organ damage including lower eGFR and higher pulse pressure.
Home BPV linked to pulse pressure and eGFR in treated hypertension; leaves open whether variability-targeted interventions improve outcomes.
Blood pressure variability (BPV) represents a cardiovascular risk factor, regardless of mean level of blood pressure (BP). In this post-hoc analysis from the PERson-centredness in Hypertension management using Information Technology (PERHIT) study, we aimed to explore BPV in daily home measurements in hypertensive patients from primary care, to identify factors associated with high BPV and to investigate whether estimated glomerular filtration rate (eGFR) and pulse pressure, as markers of target organ damage (TOD), are associated with BPV. For eight consecutive weeks, 454 participants reported their daily BP and heart rate in their mobile phone, along with reports of lifestyle and hypertension-related factors. Systolic BP (SBP) values were used to calculate BPV with coefficient of variation (CV) as primary estimate. Background characteristics and self-reports were tested between fifths of CV in a linear regression model, adjusted for age and sex. Associations between BPV and eGFR and pulse pressure were tested with linear and logistic regression models. Higher home BPV was associated with higher age, BP, heart rate, and smoking. BPV was lower for participants with low alcohol consumption and treatment with calcium channel blockers. There was a significant association between BPV and pulse pressure (P = 0.015), and between BPV and eGFR (P = 0.049). Participants with high BPV reported more dizziness and palpitations. In conclusion, pulse pressure and eGFR were significantly associated with home BPV. Older age, high BP, heart rate, and smoking were associated with high BPV, but treatment with calcium channel blockers and low alcohol consumption was associated with low BPV. Trial registration: The study was registered with ClinicalTrials.gov [NCT03554382].
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Andersson et al. (2023) conducted an observational in Treated hypertension (n=454). Home blood pressure variability vs. Lower blood pressure variability was evaluated on Association of home blood pressure variability with pulse pressure and eGFR (p=0.015 for pulse pressure, 0.049 for eGFR). Higher home blood pressure variability was significantly associated with higher pulse pressure (P=0.015) and lower estimated glomerular filtration rate (P=0.049) in patients with treated hypertension.
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