Within-Visit Blood Pressure Variability and Cardiovascular Risk in ELSA-Brasil Study Participants

Abstract Background Blood pressure variability (BPV) is of prognostic value for fatal and non-fatal cardiovascular outcomes. Objective This study aimed to evaluate the association between within-visit BPV and cardiovascular risk among participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Methods The present cross-sectional study was carried out using baseline data (2008-2010) of 14,357 ELSA-Brasil participants with no prior history of cardiovascular disease. Within-visit BPV was quantified by the coefficient of variation of three standardized systolic blood pressure (SBP) measurements using an oscillometer. Anthropometric measurements and laboratory tests were also performed. Cardiovascular risk was assessed using the atherosclerotic cardiovascular disease risk estimator (ASCVD) and multivariate logistic regression analysis was employed with a significance level of 5%. Results Significantly higher cardiovascular risk was determined by increased BPV for both sexes. A significantly higher prevalence of high risk was found in men than women across all quartiles, with the highest difference observed in the fourth quartile of variability (48.3% vs. 17.1%). Comparisons among quartiles in each sex revealed a significantly higher cardiovascular risk for men in the third (OR=1.20; 95%CI: 1.02 - 1.40) and fourth quartiles (OR=1.46; 95%CI: 1.25 -1.71), and for women in the fourth quartile (OR=1.27; 95%CI: 1.03 - 1.57). Conclusion Analysis of baseline data of the ELSA-Brasil participants revealed that blood pressure variability was associated with increased cardiovascular risk, especially in men.

背景：血压变异性（Blood pressure variability, BPV）对致死性与非致死性心血管结局具有预后评估价值。
研究目的：本研究旨在评估巴西成人健康纵向研究（Brazilian Longitudinal Study of Adult Health, ELSA-Brasil）中单次访视内血压变异性与心血管风险之间的关联。
研究方法：本横断面研究纳入14357名无既往心血管疾病史的ELSA-Brasil研究对象，采用其2008-2010年的基线数据开展分析。通过示波血压计完成3次标准化收缩压（systolic blood pressure, SBP）测量，以其变异系数量化单次访视内的血压变异性；同时收集人体测量学指标与实验室检测数据。采用动脉粥样硬化性心血管疾病风险评估模型（atherosclerotic cardiovascular disease risk estimator, ASCVD）评估心血管风险，以检验水准α=5%开展多因素logistic回归分析。
研究结果：无论男性还是女性，血压变异性升高均与更高的心血管风险显著相关。各四分位数组中男性的高心血管风险患病率均显著高于女性，其中以血压变异性第四四分位数组的差异最为显著（48.3% vs. 17.1%）。按性别分层的四分位数组间比较显示，男性第三四分位数组（比值比[odds ratio, OR]=1.20；95%置信区间[95% confidence interval, 95%CI]: 1.02~1.40）与第四四分位数组（OR=1.46；95%CI: 1.25~1.71）的心血管风险显著升高，女性仅第四四分位数组（OR=1.27；95%CI: 1.03~1.57）的心血管风险显著升高。
研究结论：对ELSA-Brasil研究对象的基线数据分析显示，血压变异性升高与心血管风险增加显著相关，这一关联在男性群体中尤为显著。