24-Hour Blood Pressure Variability Assessed by Average Real Variability: A Systematic Review and Meta-Analysis

Authors

Luis J. Mena
Vanessa G. Felix
Jesus D. Melgarejo, The University of Texas Rio Grande ValleyFollow
Gladys E. Maestre, The University of Texas Rio Grande ValleyFollow

Document Type

Article

Publication Date

10-2017

Abstract

Background-—Although 24-hour blood pressure (BP) variability (BPV) is predictive of cardiovascular outcomes independent of absolute BP levels, it is not regularly assessed in clinical practice. One possible limitation to routine BPV assessment is the lack of standardized methods for accurately estimating 24-hour BPV. We conducted a systematic review to assess the predictive power of reported BPV indexes to address appropriate quantification of 24-hour BPV, including the average real variability (ARV) index.

Methods and Results-—Studies chosen for review were those that presented data for 24-hour BPV in adults from meta-analysis, longitudinal or cross-sectional design, and examined BPV in terms of the following issues: (1) methods used to calculate and evaluate ARV; (2) assessment of 24-hour BPV determined using noninvasive ambulatory BP monitoring; (3) multivariate analysis adjusted for covariates, including some measure of BP; (4) association of 24-hour BPV with subclinical organ damage; and (5) the predictive value of 24-hour BPV on target organ damage and rate of cardiovascular events. Of the 19 assessed studies, 17 reported significant associations between high ARV and the presence and progression of subclinical organ damage, as well as the incidence of hard end points, such as cardiovascular events. In all these cases, ARV remained a significant independent predictor (P

Conclusions-—Current evidence suggests that ARV index adds significant prognostic information to 24-hour ambulatory BP monitoring and is a useful approach for studying the clinical value of BPV.

Comments

© 2017 The Authors. Original published version available at https://doi.org/10.1161/JAHA.117.006895

Recommended Citation

Mena Luis J., Felix Vanessa G., Melgarejo Jesus D., & Maestre Gladys E. (2017). 24‐Hour Blood Pressure Variability Assessed by Average Real Variability: A Systematic Review and Meta‐Analysis. Journal of the American Heart Association, 6(10), e006895. https://doi.org/10.1161/JAHA.117.006895

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Publication Title

Journal of the American Heart Association

DOI

10.1161/JAHA.117.006895

Academic Level

faculty

Mentor/PI Department

Neuroscience