Systolic blood pressure variability: risk of cardiovascular events, chronic kidney disease, dementia, and death

作者：Xunjie Cheng, Chao Song, Feiyun Ouyang, Tianqi Ma, Lingfang He, Fang Fang, Guogang Zhang, Jiaqi Huang, Yongping Bai · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf256 · 被引用次数：35 · 研究领域：Blood Pressure and Hypertension Studies、Heart Rate Variability and Autonomic Control、Heart rate and cardiovascular health

BACKGROUND AND AIMS: Earlier studies evaluated the association between systolic blood pressure variability (SBPV) measured during a single period and risk of health outcomes. This study expanded upon existing evidence by examining the association between changes in SBPV over time and clinical outcomes in primary care settings. METHODS: Visit-to-visit SBPV was determined as standard deviation of ≥3 systolic blood pressure values measured at 5-10 (Period 1) and 0-5 (Period 2) years before enrolment in the UK Biobank. Cox proportional hazards models were used to evaluate associations of absolute changes in SBPV and SBPV change patterns between these two periods with risk of cardiovascular disease (CVD), coronary heart disease (CHD), stroke, atrial fibrillation and flutter (AF), heart failure (HF), chronic kidney disease (CKD), dementia, and overall mortality. RESULTS: A total of 36 251 participants were included with a median follow-up time of 13.9 years. In the fully adjusted models, an increased SBPV from Period 1 to Period 2 was significantly associated with an increased risk of CVD, CHD, stroke, CKD, and overall mortality (all P for trend < .005), reflecting a 23%-33% increased risk comparing participants with an increase in SBPV above Tertile 3 with those below Tertile 1. An increase in SBPV from Period 1 to Period 2 appeared to be associated with an increased risk of AF, HF, and dementia; however, the associations did not reach statistical significance at P < .005. The res...