What is the clinical evidence from this study?

Study design: Editorial. Population: Community-based older adults (n=1877). Intervention: Visit-to-visit diastolic blood pressure variability. Primary outcome: All-cause and cardiovascular disease (CVD) mortality.

September 29, 2016American Journal of Hypertension

Visit-to-Visit Blood Pressure Variability—What is the current challenge?

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Why the study?

Does visit-to-visit blood pressure variability predict all-cause and cardiovascular mortality in older adults?

Population

1,877 well-functioning older adults 70–79 years of age from the Health, Aging, and Body Composition Study.

Design

Editorial

Follow-up

average of 8.5 years

Key result

Higher visit-to-visit diastolic blood pressure variability, but not systolic variability, was associated with higher all-cause and cardiovascular disease mortality in older adults.

Authors

YYYuichiro Yano

Discussion

Member takes

Overview

Diastolic BP variability may flag higher mortality risk in older adults but should not yet change practice; leaves open causality versus epiphenomenon.

Structured PICO

Does visit-to-visit blood pressure variability predict all-cause and cardiovascular mortality in older adults?

Population

1,877 well-functioning community-based older adults aged 70-79 years, followed for an average of 8.5 years to assess the impact of visit-to-visit blood pressure variability.

Exposure

Visit-to-visit blood pressure (SBP/DBP) variability

Outcome

All-cause and cardiovascular disease (CVD) mortalityhard clinical

This editorial highlights that visit-to-visit diastolic blood pressure variability is associated with increased all-cause and cardiovascular mortality in older adults, though its role as a causal risk factor versus an epiphenomenon remains unclear.

Limitations

Distinguishing BP variability from systemic changes in BP level over time is difficult.
Estimation of residual SD is based on the assumption that a participant's BP increases linearly over time.
Estimation of VIM is derived from the distribution of BP within each cohort, and thus the value itself cannot be compared across populations.
DBP is generally more difficult than SBP to measure precisely.
Whether visit-to-visit BP variability in older adults is a contributor to adverse outcomes or merely an epiphenomenon remains uncertain.
Uncertain whether visit-to-visit BP variability is a contributor to adverse outcomes or merely an epiphenomenon of certain pathological conditions
DBP is generally more difficult than SBP to measure precisely, questioning its clinical relevance in real-world medical practice

Cite This Study

Yuichiro Yano (2016) conducted an editorial in Community-based older adults (n=1,877). Visit-to-visit diastolic blood pressure variability was evaluated on All-cause and cardiovascular disease (CVD) mortality. Higher visit-to-visit diastolic blood pressure variability, but not systolic variability, was associated with higher all-cause and cardiovascular disease mortality in older adults.

synapsesocial.com/papers/6a7f422cb4cedf233c7ca398 https://doi.org/10.1093/ajh/hpw124

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September 29, 2016American Journal of Hypertension

Visit-to-Visit Blood Pressure Variability—What is the current challenge?

View Full Paper

Ask AI

Bookmark

Why the study?

Does visit-to-visit blood pressure variability predict all-cause and cardiovascular mortality in older adults?

Population

1,877 well-functioning older adults 70–79 years of age from the Health, Aging, and Body Composition Study.

Design

Editorial

Follow-up

average of 8.5 years

Key result

Higher visit-to-visit diastolic blood pressure variability, but not systolic variability, was associated with higher all-cause and cardiovascular disease mortality in older adults.

Authors

YYYuichiro Yano

Discussion

Member takes

Overview

Diastolic BP variability may flag higher mortality risk in older adults but should not yet change practice; leaves open causality versus epiphenomenon.

Structured PICO

Does visit-to-visit blood pressure variability predict all-cause and cardiovascular mortality in older adults?

Population

1,877 well-functioning community-based older adults aged 70-79 years, followed for an average of 8.5 years to assess the impact of visit-to-visit blood pressure variability.

Exposure

Visit-to-visit blood pressure (SBP/DBP) variability

Outcome

All-cause and cardiovascular disease (CVD) mortalityhard clinical

Limitations

Distinguishing BP variability from systemic changes in BP level over time is difficult.
Estimation of residual SD is based on the assumption that a participant's BP increases linearly over time.
Estimation of VIM is derived from the distribution of BP within each cohort, and thus the value itself cannot be compared across populations.
DBP is generally more difficult than SBP to measure precisely.
Whether visit-to-visit BP variability in older adults is a contributor to adverse outcomes or merely an epiphenomenon remains uncertain.
Uncertain whether visit-to-visit BP variability is a contributor to adverse outcomes or merely an epiphenomenon of certain pathological conditions
DBP is generally more difficult than SBP to measure precisely, questioning its clinical relevance in real-world medical practice

Cite This Study

synapsesocial.com/papers/6a7f422cb4cedf233c7ca398 https://doi.org/10.1093/ajh/hpw124

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