Systolic BP Variability in Young Adults May ID Later CVD Risk
Variability independent of the mean in SBP in young adults linked to CVD events, all-cause mortality
THURSDAY, Jan. 23, 2020 (HealthDay News) -- Variability in systolic blood pressure (SBP) in young adults is associated with an increased subsequent risk for cardiovascular disease (CVD) events and all-cause mortality, according to a study published online Jan. 22 in JAMA Cardiology.
Yuichiro Yano, M.D., Ph.D., from Duke University in Durham, North Carolina, and colleagues conducted a prospective cohort study involving 3,394 African-American and white young adults. Patterns of SBP were assessed, with measurements at baseline and during 10 years. Visit-to-visit variability in SBP was estimated as variability independent of the mean (VIM).
The researchers identified 162 CVD events and 181 deaths during a median follow-up of 20.0 years. When all BP pattern measurements were entered into the same model, including a single SBP measurement at the year 10 examination, for each one-standard deviation increase in SBP measures, the hazard ratios for CVD events were 1.25 (95 percent confidence interval [CI], 0.90 to 1.74) for mean SBP, 1.23 (95 percent CI, 1.07 to 1.43) for VIM SBP, and 0.99 (95 percent CI, 0.81 to 1.26) for annual change of SBP. The only BP pattern associated with all-cause mortality was VIM for SBP (hazard ratio, 1.24; 95 percent CI, 1.09 to 1.41).
"Current guidelines defining hypertension and assessing the need for antihypertensive therapies ignore variability in blood pressure readings," Yano said in a statement. "I think there has been a belief that variability is a chance phenomenon, but this research indicates maybe not. Variability matters."
Several authors disclosed financial ties to the pharmaceutical industry.