Prognostic Significance of Visit‐to‐Visit Systolic Blood Pressure Variability: A Meta‐Analysis of 77,299 Patients

作者：Chenhui Tai, Yuxi Sun, Neng Dai, Dachun Xu, Wei Chen, Ji‐Guang Wang, Athanase D. Protogerou, Thomas T. van Sloten, Jacques Blacher, Michel E. Safar, Yi Zhang, Yawei Xu · 发表于：Journal of Clinical Hypertension · 年份：2015 · DOI：10.1111/jch.12484 · 被引用次数：85 · 研究领域：Blood Pressure and Hypertension Studies、Cardiovascular Health and Disease Prevention、Heart Rate Variability and Autonomic Control

In recent clinical investigations, visit-to-visit systolic blood pressure (SBP) variability was proven as a predictor of cardiovascular events and all-cause mortality. However, inconsistent results exist in this association. A meta-analysis of 13 prospective studies was conducted to evaluate the prognostic value of visit-to-visit SBP variability by different parameters in 77,299 patients with a mean follow-up of 6.3 years. The pooled age- and mean SBP-adjusted hazard ratios (HRs) for all-cause mortality were 1.03 (95% confidence interval [CI], 1.02-1.04; P<.001) per 1-mm Hg increase in SBP standard deviation (SD) and 1.04 (1.02-1.06, P<.001) per 1% in SBP coefficient of variation, and the corresponding values of cardiovascular mortality were 1.10 (1.02-1.17, P<.001) and 1.01 (0.99-1.03, P=.32), respectively. Moreover, a 1-mm Hg increase in SD was significantly associated with stroke, with an HR of 1.02 (1.01-1.03, P<.001). Visit-to-visit SBP variability, independent of age and mean SBP, is a predictor of cardiovascular and all-cause mortality and stroke.