Prognostic Significance of Blood Pressure and Heart Rate Variabilities

TLDR

The study aimed to examine how short‑term blood‑pressure and heart‑rate variability predict cardiovascular mortality in a long‑term prospective cohort from Ohasama, Japan. Ambulatory blood‑pressure and heart‑rate monitoring was performed on 1,542 adults aged ≥40, with variability calculated as the 30‑minute standard deviation. Higher daytime systolic BP variability and lower daytime HR variability were independently associated with a linear increase in cardiovascular mortality, with the greatest risk in participants exceeding the third quintile of systolic BP variability and below mean‑SD HR variability.

Abstract

Abstract —To investigate the association between cardiovascular mortality and short-term variabilities in blood pressure and heart rate, we performed a long-term prospective study of ambulatory blood pressure monitoring in Ohasama, Japan, starting in 1987. We obtained ambulatory blood pressure and heart rate in 1542 subjects ≥40 years of age. Blood pressure and heart rate variabilities were estimated as a standard deviation measured every 30 minutes by ambulatory monitoring. There were 67 cardiovascular deaths during the follow-up period (mean=8.5 years). The Cox proportional hazards model, adjusted for possible confounding factors, demonstrated a significant increase in cardiovascular mortality, with an increase in daytime systolic ambulatory blood pressure variability. A similar trend was observed in daytime diastolic and nighttime ambulatory blood pressures. Cardiovascular mortality rate increased linearly, with a decrease in daytime heart rate variability. Subjects in whom the daytime systolic ambulatory blood pressure variability was larger than third quintile and the daytime heart rate variability was lower than the mean−SD were at extremely high risk of cardiovascular mortality. The blood pressure and heart rate variabilities obtained every 30 minutes by ambulatory blood pressure monitoring were independent predictors for cardiovascular mortality in the general population.