Within-Visit Variability of Blood Pressure and All-Cause and Cardiovascular Mortality Among US Adults
Version of Record online: 24 JAN 2012
© 2012 Wiley Periodicals, Inc.
The Journal of Clinical Hypertension
Volume 14, Issue 3, pages 165–171, March 2012
How to Cite
Muntner, P., Levitan, E. B., Reynolds, K., Mann, D. M., Tonelli, M., Oparil, S. and Shimbo, D. (2012), Within-Visit Variability of Blood Pressure and All-Cause and Cardiovascular Mortality Among US Adults. The Journal of Clinical Hypertension, 14: 165–171. doi: 10.1111/j.1751-7176.2011.00581.x
- Issue online: 28 FEB 2012
- Version of Record online: 24 JAN 2012
- Manuscript received: August 9, 2011; accepted: November 2, 2011
J Clin Hypertens (Greenwich). 2012;14:165–171. ©2012 Wiley Periodicals, Inc.
The association between within-visit variability of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and all-cause and cardiovascular (CVD) mortality was examined using the Third National Health and Nutrition Survey (n=15,317). Three SBP and DBP readings were taken by physicians during a single medical evaluation. Within-visit variability for each participant was defined using the standard deviation of SBP and DBP across these measurements. Mortality was assessed over 14 years (n=3848 and n=1684 deaths from all causes and CVD, respectively). After age, sex, and race-ethnicity adjustment, the hazard ratios (95% confidence intervals) for all-cause mortality associated with the 4 highest quintiles of within-visit standard deviation of SBP (2.00–2.99 mm Hg, 3.00–3.99 mm Hg, 4.00–5.29 mm Hg, and ≥5.30 mm Hg) compared with participants in the lowest quintile of within-visit standard deviation of SBP (<2.0 mm Hg) were 1.04 (0.87–1.26), 1.09 (0.92–1.29), 1.06 (0.88–1.28), and 1.13 (0.95–1.33), respectively (P=.136). The analogous hazard ratios for CVD mortality were 0.95 (0.69–1.32), 0.96 (0.67–1.36), 0.95 (0.74–1.23), and 1.04 (0.80–1.35), respectively (P=.566). No association with mortality was present after further adjustment and when modeling within-visit standard deviation of SBP as a continuous variable. Standard deviation of DBP was not associated with mortality.