Elevated blood pressure variability is associated with an increased risk of negative health outcomes in adults aged 65 and above — a systematic review and meta-analysis

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The clinical relevance of blood pressure variability (BPV) is still unknown, despite increasing evidence associating BPV to negative health outcomes (NHOs). There is currently no gold standard to define high BPV and normal reference values for BPV are lacking.

Aim: The primary aim was to examine whether high BPV can predict NHO in adults aged ≥65. The predictive value of BPV was compared to mean BP (mBP) when both parameters were available.

Methods: PubMed and Web of Science were systematically screened; 49 articles (12 retrospective, 18 prospective and 19 cross-sectional studies) were included and evaluated for methodological quality. Meta-analyses were conducted to examine the association of BPV (and mBP when available) with NHO.

Results: Systolic BPV and systolic mBP seem to indicate at least comparable odds for cardiovascular disease (BPV: odds ratio (OR) = 1.33 (95% CI: 1.19–1.48, P < .00001) vs mBP: OR = 1.06 (95% CI: 1.03–1.09, P = .0002)) and cerebral deterioration (BPV: OR = 1.28 (95% CI: 1.17–1.41, P < .00001) vs mBP: OR = 1.06 (95% CI: 1.04–1.09, P < .00001)). Increased diastolic BPV was associated with higher odds of cerebral deterioration (OR = 1.18 (95% CI: 1.04–1.35), P = .01).

Conclusion: High systolic BPV and high systolic mBP are associated with 33% and 6% higher odds of cardiovascular disease in adults aged ≥65, respectively. High BPV is also related to an 18%–28% and 11% increased odds of cerebral deterioration and poor stroke recovery. An overview of cut-off values is provided for the most often reported BPV parameters in literature, which can be used as a guideline to identify elevated BPV in clinical practice.
Original languageEnglish
Article numberafae262
Number of pages12
JournalAge & Ageing
Volume53
Issue number12
DOIs
Publication statusPublished - Dec 2024

Bibliographical note

Funding Information:
I.B. reports that financial support was provided by Vrije Universiteit Brussel (VUB). This study was partly funded by an \u2018Interdisciplinary Research Program\u2019 grant (grant n\u00B0 IRP12 and grant n\u00B0 IRP22) from the research council of the Vrije Universiteit Brussel (VUB).

Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.

Keywords

  • cerebral deterioration
  • cardiovascular regulation
  • negative health outcomes
  • autonomic function
  • arterial hypertension
  • older people
  • systematic review

Cite this