Variability in home blood pressure and its association with renal function and pulse pressure in patients with treated hypertension in primary care.
Journal
Journal of human hypertension
ISSN: 1476-5527
Titre abrégé: J Hum Hypertens
Pays: England
ID NLM: 8811625
Informations de publication
Date de publication:
Mar 2024
Mar 2024
Historique:
received:
17
03
2023
accepted:
30
10
2023
revised:
06
10
2023
medline:
18
3
2024
pubmed:
16
11
2023
entrez:
16
11
2023
Statut:
ppublish
Résumé
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].
Identifiants
pubmed: 37968455
doi: 10.1038/s41371-023-00874-2
pii: 10.1038/s41371-023-00874-2
pmc: PMC10940151
doi:
Substances chimiques
Calcium Channel Blockers
0
Banques de données
ClinicalTrials.gov
['NCT03554382']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
212-220Subventions
Organisme : Familjen Kamprads Stiftelse (Kamprad Family Foundation)
ID : 20170102
Organisme : Hjärt-Lungfonden (Swedish Heart-Lung Foundation)
ID : 20170251 / 20200507
Organisme : Vetenskapsrådet (Swedish Research Council)
ID : 2018-02648
Informations de copyright
© 2023. The Author(s).
Références
Parati G, Bilo G, Kollias A, Pengo M, Ochoa JE, Castiglioni P, et al. Blood pressure variability: methodological aspects, clinical relevance and practical indications for management - a European Society of Hypertension position paper ∗. J Hypertens. 2023;41:527–44.
doi: 10.1097/HJH.0000000000003363
pubmed: 36723481
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021–104.
doi: 10.1093/eurheartj/ehy339
pubmed: 30165516
Mehlum MH, Liestøl K, Kjeldsen SE, Julius S, Hua TA, Rothwell PM, et al. Blood pressure variability and risk of cardiovascular events and death in patients with hypertension and different baseline risks. Eur Heart J. 2018;39:2243–51.
doi: 10.1093/eurheartj/ehx760
pubmed: 29365085
Smith TO, Sillito JA, Goh CH, Abdel-Fattah AR, Einarsson A, Soiza RL, et al. Association between different methods of assessing blood pressure variability and incident cardiovascular disease, cardiovascular mortality and all-cause mortality: a systematic review. Age Ageing. 2020;49:184–92.
doi: 10.1093/ageing/afz178
pubmed: 31985773
Parati G, Stergiou GS, Bilo G, Kollias A, Pengo M, Ochoa JE, et al. Home blood pressure monitoring: methodology, clinical relevance and practical application: a 2021 position paper by the working group on blood pressure monitoring and cardiovascular variability of the European Society of Hypertension. J Hypertens. 2021;39:1742–67.
doi: 10.1097/HJH.0000000000002922
pubmed: 34269334
pmcid: 9904446
Hoshide S, Yano Y, Mizuno H, Kanegae H, Kario K. Day-by-day variability of home blood pressure and incident cardiovascular disease in clinical practice. Hypertension. 2018;71:177–84.
doi: 10.1161/HYPERTENSIONAHA.117.10385
pubmed: 29133364
Stergiou GS, Ntineri A, Kollias A, Ohkubo T, Imai Y, Parati G. Blood pressure variability assessed by home measurements: a systematic review. Hypertens Res. 2014;37:565–72.
doi: 10.1038/hr.2014.2
pubmed: 24553366
Takashima N, Ohkubo T, Miura K, Okayama A, Okuda N, Nakagawa H, et al. Factors associated with intra-individual visit-to-visit variability of blood pressure in four countries: the INTERMAP study. J Hum Hypertens. 2019;33:229–36.
doi: 10.1038/s41371-018-0129-z
pubmed: 30420643
Bencivenga L, de Souto Barreto P, Rolland Y, Hanon O, Vidal JS, Cestac P, et al. Blood pressure variability: a potential marker of aging. Ageing Res Rev. 2022;80:101677.
doi: 10.1016/j.arr.2022.101677
pubmed: 35738476
Park JS, Shin JH, Park JB, Choi DJ, Youn HJ, Park CG, et al. Relationship between arterial stiffness and variability of home blood pressure monitoring. Medicine. 2020;99:e21227.
doi: 10.1097/MD.0000000000021227
pubmed: 32791697
pmcid: 7387033
Vasan RS, Short MI, Niiranen TJ, Xanthakis V, DeCarli C, Cheng S, et al. Interrelations between arterial stiffness, target organ damage, and cardiovascular disease outcomes. J Am Heart Assoc. 2019;8:e012141.
doi: 10.1161/JAHA.119.012141
pubmed: 31303106
pmcid: 6662123
el Mokadem M, Boshra H, Abd el Hady Y, Kasla A, Gouda A. Correlation between blood pressure variability and subclinical target organ damage in patients with essential hypertension. J Hum Hypertens. 2020;34:641–7.
doi: 10.1038/s41371-019-0286-8
pubmed: 31712711
Chia YC, Lim HM, Ching SM. Long-term visit-to-visit blood pressure variability and renal function decline in patients with hypertension over 15 years. J Am Heart Assoc. 2016;5:e003825.
doi: 10.1161/JAHA.116.003825
pubmed: 27821404
pmcid: 5210361
Kubozono T, Akasaki Y, Kawasoe S, Ojima S, Kawabata T, Makizako H, et al. The relationship between day-to-day variability in home blood pressure measurement and multiple organ function. Hypertens Res. 2022;45:474–82.
doi: 10.1038/s41440-021-00818-8
pubmed: 34934161
Suzuki D, Hoshide S, Kario K. Associations between day-by-day home blood pressure variability and renal function and albuminuria in patients with and without diabetes. Am J Hypertens. 2020;33:860–8.
doi: 10.1093/ajh/hpaa091
pubmed: 32531041
Mancusi C, Losi MA, Izzo R, Canciello G, Carlino MV, Albano G, et al. Higher pulse pressure and risk for cardiovascular events in patients with essential hypertension: The Campania Salute Network. Eur J Prev Cardiol. 2018;25:235–43.
doi: 10.1177/2047487317747498
pubmed: 29226693
Andersson U, Nilsson PM, Kjellgren K, Hoffmann M, Wennersten A, Midlöv P. PERson-centredness in Hypertension management using Information Technology: a randomized controlled trial in primary care. J Hypertens. 2023;41:246–53.
doi: 10.1097/HJH.0000000000003322
pubmed: 36394295
Midlöv P, Nilsson PM, Bengtsson U, Hoffmann M, Wennersten A, Andersson U, et al. PERson-centredness in hypertension management using information technology (PERHIT): a protocol for a randomised controlled trial in primary health care. Blood Press. 2020;29:149–56.
doi: 10.1080/08037051.2019.1697177
pubmed: 31814476
Andersson U, Bengtsson U, Ranerup A, Midlöv P, Kjellgren K. Patients and professionals as partners in hypertension care: qualitative substudy of a randomized controlled trial using an interactive web-based system via mobile phone. J Med Internet Res. 2021;23:e26143.
doi: 10.2196/26143
pubmed: 34081021
pmcid: 8212623
Rothwell PM, Howard SC, Dolan E, O’brien E, Dobson JE, Dahlöf B, et al. Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. Lancet. 2010;375:895–905.
doi: 10.1016/S0140-6736(10)60308-X
pubmed: 20226988
del Giorno R, Balestra L, Heiniger PS, Gabutti L. Blood pressure variability with different measurement methods: reliability and predictors. A proof of concept cross sectional study in elderly hypertensive hospitalized patients. Med (US). 2019;98:e16347.
Grubb A, Nyman U, Björk J. Improved estimation of glomerular filtration rate (GFR) by comparison of eGFR
doi: 10.3109/00365513.2011.634023
pubmed: 22121923
Nyman U, Grubb A, Larsson A, Hansson LO, Flodin M, Nordin G, et al. The revised Lund-Malmö GFR estimating equation outperforms MDRD and CKD-EPI across GFR, age and BMI intervals in a large Swedish population. Clin Chem Lab Med. 2014;52:815–24.
doi: 10.1515/cclm-2013-0741
pubmed: 24334413
Boubouchairopoulou N, Ntineri A, Kollias A, Destounis A, Stergiou GS. Blood pressure variability assessed by office, home, and ambulatory measurements: comparison, agreement, and determinants. Hypertens Res. 2021;44:1617–24.
doi: 10.1038/s41440-021-00736-9
pubmed: 34599293
Ishikura K, Obara T, Kato T, Kikuya M, Shibamiya T, Shinki T, et al. Associations between day-by-day variability in blood pressure measured at home and antihypertensive drugs: The J-HOME-morning study home. Clin Exp Hypertens. 2012;34:297–304.
doi: 10.3109/10641963.2012.681087
pubmed: 22564087
Reule S, Drawz PE. Heart rate and blood pressure: any possible implications for management of hypertension. Curr Hypertens Rep. 2012;14:478–84.
doi: 10.1007/s11906-012-0306-3
pubmed: 22972532
pmcid: 3491126
Hwang CL, Muchira J, Hibner BA, Phillips SA, Piano MR. Alcohol consumption: a new risk factor for arterial stiffness? Cardiovasc Toxicol. 2022;22:236–45.
doi: 10.1007/s12012-022-09728-8
pubmed: 35195845
pmcid: 8863568
del Giorno R, Maddalena A, Bassetti S, Gabutti L. Association between alcohol intake and arterial stiffness in healthy adults: a systematic review. Nutrients. 2022;14:1207.
doi: 10.3390/nu14061207
pubmed: 35334865
pmcid: 8949071
Fukui M, Ushigome E, Tanaka M, Hamaguchi M, Tanaka T, Atsuta H, et al. Home blood pressure variability on one occasion is a novel factor associated with arterial stiffness in patients with type 2 diabetes. Hypertens Res. 2013;36:219–25.
doi: 10.1038/hr.2012.177
pubmed: 23096230
Lee JW, Choi E, Son JW, Youn YJ, Ahn SG, Ahn MS, et al. Comparison of blood pressure variability between losartan and amlodipine in essential hypertension (COMPAS-BPV). Am J Hypertens. 2020;33:748–55.
doi: 10.1093/ajh/hpaa060
pubmed: 32267481
Lin GM, Tsai KZ, Lin CS, Han CL. Physical fitness and long-term blood pressure variability in young male military personnel. Curr Hypertens Rev. 2019;16:156–60.
doi: 10.2174/1573402115666191023111351
Uusitalo ALT, Laitinen T, Väisänen SB, Länsimies E, Rauramaa R. Physical training and heart rate and blood pressure variability: a 5-yr randomized trial. Am J Physiol Heart Circ Physiol. 2004;286:1821–6.
doi: 10.1152/ajpheart.00600.2003
Maseli A, Aeschbacher S, Schoen T, Fischer A, Jung M, Risch M, et al. Healthy lifestyle and blood pressure variability in young adults. Am J Hypertens. 2017;30:690–9.
doi: 10.1093/ajh/hpx034
pubmed: 28402434
Safar ME. Arterial stiffness as a risk factor for clinical hypertension. Nat Rev Cardiol. 2018;15:97–105.
doi: 10.1038/nrcardio.2017.155
pubmed: 29022570
Mokhtari A, Bellinetto-Ford L, Melander O, Nilsson PM. Determinants of increasing pulse pressure during 23 years’ follow-up as a marker of arterial stiffness and vascular ageing. Blood Press. 2008;17:291–7.
doi: 10.1080/08037050802584313
pubmed: 19048424
Imai Y, Aihara A, Ohkubo T, Nagai K, Tsuji I, Minami N, et al. Factors that affect blood pressure variability a community-based study in Ohasama, Japan. Am J Hypertens Ltd AJH. 1997;10:1281–9.
doi: 10.1016/S0895-7061(97)00277-X