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Growing evidences suggest visit–to–visit variability (VVV) of blood pressure is associated with stroke incidence. We aimed to assess the correlation between VVV and stroke in real–world Chinese hypertensive population.
The data were obtained from Electric Health Recording System (EHRS) of Shanghai Minhang District of China. A total of 122,636 adult hypertensive patients (≥ 18 years of age) without previous stroke were followed during January 1, 2005 to July 31, 2011. And over six blood pressure recordings were taken during the visits. We expressed VVV of systolic and diastolic pressure (SBP and DBP) as standard deviation (SD–SBP and SD–DBP) and coefficient of variation (CV–SBP and CV–DBP), respectively. Multivariable hazards ratios and 95% confidence intervals (95% CI) were evaluated, adjusting for blood pressure and baseline characteristics.
Stroke was assessed in 4,522 (3.69%) patients during a median follow–up of 38 months. The mean SD for SBP across the visits was 8.87 mmHg. Multivariable hazards ratios for stroke associated with a SD–SBP of quartile 2 (6.61 to 8.50 mmHg), quartile 3 (8.50 to 10.74 mmHg) and quartile 4 (10.74 to 37.70 mmHg), versus quartile 1 (≤6.61 mmHg), were 1.48 (95% CI, 1.33 to 1.64), 1.66 (95% CI, 1.50 to 1.84), 1.78 (95% CI, 1.61 to 1.98), respectively. The mean SD for DBP across the visits was 5.80 mmHg. Multivariable hazards ratios for stroke associated with a SD–DBP of quartile 2 (4.53 to 5.66 mmHg), quartile 3 (5.66 to 6.94 mmHg) and quartile 4 (6.94 to 22.66 mmHg), versus quartile 1 (≤4.53 mmHg), were 1.46 (95% CI, 1.32 to 1.61), 1.56 (95% CI, 1.41 to 1.72) and 1.62 (95% CI: 1.47 to 1.80), respectively. The results were similar when CV–SBP and CV–DBP were analyzed. Higher levels of VVV were associated with the increased stroke in the subgroups with ischemic stroke, hemorrhage stroke and transient ischemic attack, respectively.
Higher level of VVV was associated with a significant increase of stroke incidence, and might be independent predictor for stroke occurrence in Chinese population.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Atherosclerosis, Inflammation, Biomarkers and Outcomes: What's New?
Abstract Category: 35. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1124–159
- 2013 American College of Cardiology Foundation