ArticleJournal of hypertension2020
Prognostic importance of long-term SBP variability in high-risk hypertension.
Article in Journal of hypertension, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Effects of aerobic and resistance exercise on patients with hypertension: a systematic review and meta-analysis focusing on the sympathetic nervous system.Frontiers in cardiovascular medicine · 2025Pooled it
- Impact of Blood Pressure on Risk of Graft Failure or Death Among Patients After Kidney Transplantation in a 10-Year Observational Period: A Single-Center Retrospective Analysis.Annals of transplantation · 2023Observational
- Differences in Heart Rate Variability and Baroreflex Sensitivity between Male and Female Athletes.Journal of clinical medicine · 2023Article
- Impact of blood pressure changes on myocardial work indices in hypertensive patients in a day.Journal of clinical hypertension (Greenwich, Conn.) · 2022Article
- Impact of Guidelines on Hypertension Control in the Elderly.Current pharmaceutical design · 2021Article
- Long-term BP variability: open questions in clinical practice.International Journal of Cardiology. Hypertension · 2020Article
- Periodontitis and Hypertension: Is the Association Causal?High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2020Review
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
objectiveIn addition to high blood pressure variability (BPV), low BPV was associated with adverse cardiovascular prognosis in selected high-risk patients. We explored this issue in the Systolic Blood Pressure Intervention Trial (SPRINT) using a nonlinear approach with BPV as a continuous variable.
methodsLong-term systolic BPV (SBPV) (coefficient of variation, CoV %) was calculated on quarterly visits until a fatal/nonfatal cardiovascular event or all-cause mortality, excluding titration period and patients with missing visits. We used Cox proportional hazard models with penalized smoothing splines to shape the risk of outcomes against the continuum of SBPV (independent variable). Adjusted hazard ratios (aHR, 95% CI) were calculated using the reference range derived from the nonlinear model. Sensitivity analysis based on propensity score matching (PSM) was performed.
resultsThe association of SBPV with fatal/nonfatal cardiovascular events was J-shaped, whereas that with all-cause mortality was linear. After multivariate adjustment, however, the only significant associations remained that of low SBPV (CoV <5%) with cardiovascular events (hazard ratio 1.85, 95% CI 1.24-2.75, P = 0.003), and of high SBPV (CoV >10%) with the composite of cardiovascular events and all-cause mortality (hazard ratio 1.35, 95% CI 1.02-1.80; P = 0.037). Low SBPV was associated with ischemic heart disease (hazard ratio 2.76, 95% CI 1.55-4.91; P < 0.001). There was a significant U-shaped association of SBPV with cardiovascular events in the PSM cohort.
conclusionNonlinear modeling indicates that low and high long-term SBPV have prognostic relevance in high-risk hypertensive individuals from SPRINT. Randomized trials are needed to test these findings and their potential therapeutic implications.
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