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Variability in home blood pressure and its association with renal function and pulse pressure in patients with treated hypertension in primary care

Andersson, Ulrika LU orcid ; Nilsson, Peter M LU ; Kjellgren, Karin LU ; Harris, Katie ; Chalmers, John ; Ekholm, Mikael and Midlöv, Patrik LU orcid (2024) In Journal of Human Hypertension 38(3). p.212-220
Abstract

Blood pressure variability (BPV) represents a cardiovascular risk factor, regardless of mean level of blood pressure (BP). In this post-hoc analysis from the PERson-centredness in Hypertension management using Information Technology (PERHIT) study, we aimed to explore BPV in daily home measurements in hypertensive patients from primary care, to identify factors associated with high BPV and to investigate whether estimated glomerular filtration rate (eGFR) and pulse pressure, as markers of target organ damage (TOD), are associated with BPV. For eight consecutive weeks, 454 participants reported their daily BP and heart rate in their mobile phone, along with reports of lifestyle and hypertension-related factors. Systolic BP (SBP) values... (More)

Blood pressure variability (BPV) represents a cardiovascular risk factor, regardless of mean level of blood pressure (BP). In this post-hoc analysis from the PERson-centredness in Hypertension management using Information Technology (PERHIT) study, we aimed to explore BPV in daily home measurements in hypertensive patients from primary care, to identify factors associated with high BPV and to investigate whether estimated glomerular filtration rate (eGFR) and pulse pressure, as markers of target organ damage (TOD), are associated with BPV. For eight consecutive weeks, 454 participants reported their daily BP and heart rate in their mobile phone, along with reports of lifestyle and hypertension-related factors. Systolic BP (SBP) values were used to calculate BPV with coefficient of variation (CV) as primary estimate. Background characteristics and self-reports were tested between fifths of CV in a linear regression model, adjusted for age and sex. Associations between BPV and eGFR and pulse pressure were tested with linear and logistic regression models. Higher home BPV was associated with higher age, BP, heart rate, and smoking. BPV was lower for participants with low alcohol consumption and treatment with calcium channel blockers. There was a significant association between BPV and pulse pressure (P = 0.015), and between BPV and eGFR (P = 0.049). Participants with high BPV reported more dizziness and palpitations. In conclusion, pulse pressure and eGFR were significantly associated with home BPV. Older age, high BP, heart rate, and smoking were associated with high BPV, but treatment with calcium channel blockers and low alcohol consumption was associated with low BPV. Trial registration: The study was registered with ClinicalTrials.gov [NCT03554382].

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Human Hypertension
volume
38
issue
3
pages
9 pages
publisher
Nature Publishing Group
external identifiers
  • pmid:37968455
  • scopus:85176775929
ISSN
1476-5527
DOI
10.1038/s41371-023-00874-2
language
English
LU publication?
yes
additional info
© 2023. The Author(s).
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fd3dff22-30b5-494c-84ae-aa440bb6dc11
date added to LUP
2023-11-16 10:03:02
date last changed
2024-11-15 20:10:45
@article{fd3dff22-30b5-494c-84ae-aa440bb6dc11,
  abstract     = {{<p>Blood pressure variability (BPV) represents a cardiovascular risk factor, regardless of mean level of blood pressure (BP). In this post-hoc analysis from the PERson-centredness in Hypertension management using Information Technology (PERHIT) study, we aimed to explore BPV in daily home measurements in hypertensive patients from primary care, to identify factors associated with high BPV and to investigate whether estimated glomerular filtration rate (eGFR) and pulse pressure, as markers of target organ damage (TOD), are associated with BPV. For eight consecutive weeks, 454 participants reported their daily BP and heart rate in their mobile phone, along with reports of lifestyle and hypertension-related factors. Systolic BP (SBP) values were used to calculate BPV with coefficient of variation (CV) as primary estimate. Background characteristics and self-reports were tested between fifths of CV in a linear regression model, adjusted for age and sex. Associations between BPV and eGFR and pulse pressure were tested with linear and logistic regression models. Higher home BPV was associated with higher age, BP, heart rate, and smoking. BPV was lower for participants with low alcohol consumption and treatment with calcium channel blockers. There was a significant association between BPV and pulse pressure (P = 0.015), and between BPV and eGFR (P = 0.049). Participants with high BPV reported more dizziness and palpitations. In conclusion, pulse pressure and eGFR were significantly associated with home BPV. Older age, high BP, heart rate, and smoking were associated with high BPV, but treatment with calcium channel blockers and low alcohol consumption was associated with low BPV. Trial registration: The study was registered with ClinicalTrials.gov [NCT03554382].</p>}},
  author       = {{Andersson, Ulrika and Nilsson, Peter M and Kjellgren, Karin and Harris, Katie and Chalmers, John and Ekholm, Mikael and Midlöv, Patrik}},
  issn         = {{1476-5527}},
  language     = {{eng}},
  number       = {{3}},
  pages        = {{212--220}},
  publisher    = {{Nature Publishing Group}},
  series       = {{Journal of Human Hypertension}},
  title        = {{Variability in home blood pressure and its association with renal function and pulse pressure in patients with treated hypertension in primary care}},
  url          = {{http://dx.doi.org/10.1038/s41371-023-00874-2}},
  doi          = {{10.1038/s41371-023-00874-2}},
  volume       = {{38}},
  year         = {{2024}},
}