☆ 4.6 Article

Visit-to-visit blood pressure variability as a prognostic marker in patients with cardiovascular and cerebrovascular diseases - Relationships and comparisons with vascular markers of atherosclerosis

ATHEROSCLEROSIS (2014)

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ATHEROSCLEROSIS

卷 235, 期 1, 页码 230-235

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ELSEVIER IRELAND LTD

DOI: 10.1016/j.atherosclerosis.2014.04.015

关键词

Blood pressure variability; Vascular markers; Cardiovascular and cerebrovascular diseases

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Cardiac & Cardiovascular Systems Peripheral Vascular Disease

资金

Research Grant Committee Direct Allocation Grant of The University of Hong Kong

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Background: Visit-to-visit blood pressure variability (BPV) is a simple surrogate marker for the development of atherosclerotic diseases, cardiovascular and all-cause mortality. Nevertheless, the relative prognostic value of BPV in comparison with other established vascular assessments remain uncertain. Methods: We prospectively followed-up 656 high-risk patients with diabetes or established cardiovascular or cerebrovascular diseases for the occurrence of major adverse cardiovascular events (MACEs). Baseline brachial endothelial function, carotid intima-media thickness (IMT) and plaque burden, ankle-brachial index and arterial stiffness were determined. Visit-to-visit BPV were recorded during a mean 18 +/- 9 outpatient clinic visits. Results: After a mean 81 +/- 12 month's follow-up, 123 patients (19%) developed MACEs. Patients who developed a MACE had significantly higher systolic BPV, more severe endothelial function, arterial stiffness and systemic atherosclerotic burden compared to patients who did not develop a MACE (all P < 0.01). BPV significantly correlated with all of the vascular assessments (P < 0.01). A high carotid IMT had the greatest prognostic value in predicting development of a MACE ( area under receiver operating characteristic curve (AUC) 0.69 +/- 0.03, P < 0.01). A high BPV also had moderate prognostic value in prediction of MACE (AUC 0.65 +/- 0.03, P < 0.01). After adjustment of confounding factors, a high BPV remained a significant independent predictor of MACE (hazards ratio 1.67, 95% confidence interval 1.14-2.43, P < 0.01). Conclusions: Compared with established surrogate markers of atherosclerosis, visit-to-visit BPV provides similar prognostic information and may represent a new and simple marker for adverse outcomes in patients with vascular diseases. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

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Sex Differences in Myocardial and Vascular Aging

Hongwei Ji, Alan C. Kwan, Melanie T. Chen, David Ouyang, Joseph E. Ebinger, Susan P. Bell, Teemu J. Niiranen, Natalie A. Bello, Susan Cheng

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