Within-Visit Variability of Blood Pressure and All-Cause and Cardiovascular Mortality Among US Adults

Academic Article


  • The association between within-visit variability of systolic blood pressure (SBP) and diastolic blood pressure (DBP) and all-cause and cardiovascular (CVD) mortality was examined using the Third National Health and Nutrition Survey (n=15,317). Three SBP and DBP readings were taken by physicians during a single medical evaluation. Within-visit variability for each participant was defined using the standard deviation of SBP and DBP across these measurements. Mortality was assessed over 14years (n=3848 and n=1684 deaths from all causes and CVD, respectively). After age, sex, and race-ethnicity adjustment, the hazard ratios (95% confidence intervals) for all-cause mortality associated with the 4 highest quintiles of within-visit standard deviation of SBP (2.00-2.99 mm Hg, 3.00-3.99 mm Hg, 4.00-5.29 mm Hg, and ≥5.30mmHg) compared with participants in the lowest quintile of within-visit standard deviation of SBP (<2.0mmHg) were 1.04 (0.87-1.26), 1.09 (0.92-1.29), 1.06 (0.88-1.28), and 1.13 (0.95-1.33), respectively (P = .136). The analogous hazard ratios for CVD mortality were 0.95 (0.69-1.32), 0.96 (0.67-1.36), 0.95 (0.74-1.23), and 1.04 (0.80-1.35), respectively (P = .566). No association with mortality was present after further adjustment and when modeling within-visit standard deviation of SBP as a continuous variable. Standard deviation of DBP was not associated with mortality. © 2012 Wiley Periodicals, Inc.
  • Digital Object Identifier (doi)

    Pubmed Id

  • 12707963
  • Author List

  • Muntner P; Levitan EB; Reynolds K; Mann DM; Tonelli M; Oparil S; Shimbo D
  • Start Page

  • 165
  • End Page

  • 171
  • Volume

  • 14
  • Issue

  • 3