Trial reportAnnals of internal medicine2015
Visit-to-Visit Variability of Blood Pressure and Coronary Heart Disease, Stroke, Heart Failure, and Mortality: A Cohort Study.
Trial report in Annals of internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 173 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
173 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Prognostic value of blood pressure variability in patients with heart failure: a systematic review and meta-analysis.Journal of human hypertension · 2026Pooled it
- Visit-to-visit Systolic Blood Pressure Variability and Stroke Risk: A Systematic Review and Meta-analysis.Current medical science · 2019Pooled it
- Blood pressure variability and cardiovascular disease: systematic review and meta-analysis.BMJ (Clinical research ed.) · 2016Pooled it
- Fish, Long-Chain n-3 PUFA and Incidence of Elevated Blood Pressure: A Meta-Analysis of Prospective Cohort Studies.Nutrients · 2016Pooled it
- Blood Pressure Variability and Outcomes Across Antihypertensive Regimens.Hypertension (Dallas, Tex. : 1979) · 2026Trial
- Patient Perceptions of Provider Race Concordance and Quality of Chronic Illness Care.Journal of general internal medicine · 2025Trial
- Long-term visit-to-visit blood pressure variability and risk of cardiovascular and bleeding events: insights from the ENGAGE AF-TIMI 48 trial.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Trial
- Long-term BPV is an Independent Risk Factor for Renal Prognosis in Hypertensive Patients - a Post-hoc Analysis of the SPRINT Study.International journal of medical sciences · 2025Trial
- Impact of pulse pressure variability evaluated by visit-to-visit on heart failure events in patients with hypertension: insights from the SPRINT trial.European journal of medical research · 2024Trial
- Baseline blood pressure modifies the role of blood pressure variability in mortality: Results from the ACCORD trial.Diabetes, obesity & metabolism · 2022Trial
- Effect of dihydropyridine calcium channel blockers on blood pressure variability in the SPRINT trial: a treatment effects approach.Journal of hypertension · 2022Trial
- Refining determinants of associations of visit-to-visit blood pressure variability with cardiovascular risk: results from the Action to Control Cardiovascular Risk in Diabetes Trial.Journal of hypertension · 2021Trial
- Long-Term Blood Pressure Variability and Risk of Cardiovascular Disease Events Among Community-Dwelling Elderly.Hypertension (Dallas, Tex. : 1979) · 2020Trial
- Trial
- Disparities in Socioeconomic Context and Association With Blood Pressure Control and Cardiovascular Outcomes in ALLHAT.Journal of the American Heart Association · 2019Trial
- Sustained blood pressure control and coronary heart disease, stroke, heart failure, and mortality: An observational analysis of ALLHAT.Journal of clinical hypertension (Greenwich, Conn.) · 2019Trial
- Visit-to-Visit Glycemic Variability and Risks of Cardiovascular Events and All-Cause Mortality: The ALLHAT Study.Diabetes care · 2019Trial
- Blood pressure variability predicts adverse events and cardiovascular outcomes in SPRINT.Journal of clinical hypertension (Greenwich, Conn.) · 2018Trial
- Increased Blood Pressure Variability Contributes to Worse Outcome After Intracerebral Hemorrhage.Stroke · 2018Trial
- Systolic Blood Pressure Response in SPRINT (Systolic Blood Pressure Intervention Trial) and ACCORD (Action to Control Cardiovascular Risk in Diabetes): A Possible Explanation for Discordant Trial Results.Journal of the American Heart Association · 2017Trial
113 more citing papers are in PubMed but not listed here.
Corrections and comments
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- SummaryForPatientsIn
Authors and funding
12 authors.
Funding
Abstract
backgroundVariability of blood pressure (BP) across outpatient visits is frequently dismissed as random fluctuation around a patient's underlying BP.
objectiveTo examine the association of visit-to-visit variability (VVV) of systolic BP (SBP) and diastolic BP with cardiovascular disease (CVD) and mortality outcomes.
designProspective cohort study.
settingPost hoc analysis of ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial).
participants25 814 ALLHAT participants. MEASUREMENTS: The VVV of SBP was defined as the SD across SBP measurements obtained at 7 visits conducted from 6 to 28 months after ALLHAT enrollment. Participants without CVD events during the first 28 months of follow-up were followed from the 28-month visit through the end of active ALLHAT follow-up. Outcomes included fatal coronary heart disease (CHD) or nonfatal myocardial infarction, all-cause mortality, stroke, and heart failure.
resultsDuring follow-up, 1194 fatal CHD or nonfatal MI events, 1948 deaths, 606 strokes, and 921 heart failure events occurred. After multivariable adjustment, including for mean SBP, the hazard ratio comparing participants in the highest versus lowest quintile of SD of SBP (≥14.4 mm Hg vs. <6.5 mm Hg) was 1.30 (95% CI, 1.06 to 1.59) for fatal CHD or nonfatal MI, 1.58 (CI, 1.32 to 1.90) for all-cause mortality, 1.46 (CI, 1.06 to 2.01) for stroke, and 1.25 (CI, 0.97 to 1.61) for heart failure. Higher VVV of diastolic BP was also associated with CVD events and mortality. LIMITATION: Long-term outcomes were not available.
conclusionHigher VVV of SBP is associated with an increased risk for CVD and mortality. Future studies should examine whether reducing VVV of BP lowers this risk. PRIMARY FUNDING SOURCE: National Institutes of Health.
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Registered trials
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