J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 7, Number 7, July 2015, pages 545-550

Association Between Visit-to-Visit Variability in Blood Pressure and Cardiovascular Events in Hypertensive Patients After Successful Percutaneous Coronary Intervention

Figure 1. Visit-to-visit variability (VVV) in systolic blood pressure (SBP) and maximum SBP in patients with or without major adverse cardiovascular events (MACEs) and myocardial infarction (MI) in the acute coronary syndrome (ACS) and stable angina pectoris (SAP) groups.

**Table 1.** Patient Characteristics at Baseline in All Patients and the ACS and SAP Groups
	All patients	ACS	SAP
SAP: stable angina pectoris; ACS: acute coronary syndrome; BMI: body mass index; MI: myocardial infarction; CABG: coronary artery bypass graft; PCI: percutaneous coronary intervention; SBP: systolic blood pressure; DBP: diastolic blood pressure; DL: dyslipidemia; TG: triglyceride; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; DM: diabetes mellitus; HbA1c: hemoglobin A1c; LVEF: left ventricular ejection fraction; eGFR: estimated glomerular filtration rate; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker; OHA: oral hypoglycemic agent; RCA: right coronary artery; LAD: left anterior descending coronary artery; LCx: left circumflex coronary artery; LMT: left main trunk; BG: bypass graft; BMS: bare-metal stent; DES: drug-eluting stent; POBA: plain old balloon angioplasty. P < 0.05, *P < 0.01 vs. SAP group.
No. of patients	176	50	126
Age, years	69 ± 11	68 ± 11	70 ± 11
Male, n (%)	143 (81)	43 (86)	100 (79)
BMI, kg/m²	24.0 ± 3.5	24.2 ± 3.5	24.0 ± 3.5
Smoking, %	106 (60)	30 (60)	76 (60)
Prior MI, n (%)	40 (23)	9 (18)	31 (25)
Prior PCI, n (%)	65 (37)	12 (24)*	53 (42)
Prior CABG, n (%)	13 (7)	5 (10)	8 (6)
SBP, mm Hg	130 ± 19	128 ± 22	131 ± 16
DBP, mm Hg	73 ± 14	76 ± 16	72 ± 13
DL, %	163 (93)	48 (96)	115 (91)
TG, mg/dL	133 ± 85	121 ± 74	138 ± 89
LDL-C, mg/dL	99 ± 31	103 ± 34	97 ± 30
HDL-C, mg/dL	46 ± 12	45 ± 11	47 ± 12
DM, %	69 (39)	17 (34)	52 (41)
HbA1c, %	6.3 ± 1.2	6.2 ± 1.3	6.3 ± 1.2
LVEF, %	60 ± 15	54 ± 16*	62 ± 14
eGFR	61 ± 21	65 ± 24	59 ± 20
Medications
ARB/ACE-I	147 (84)	44 (88)	103 (82)
CCB	131 (74)	32 (64)*	99 (79)
β-blocker	66 (38)	27 (54)**	39 (31)
Diuretics	34 (19)	12 (24)	22 (17)
Statin	155 (88)	45 (90)	110 (87)
Nitrate	118 (67)	28 (56)*	90 (78)
Nicorandil	30 (17)	9 (18)	21 (17)
OHA	43 (24)	13 (26)	30 (24)
Insulin	7 (4)	2 (4)	5 (4)
Target vessels of PCI
RCA/LAD/LCx/LMT/BG, n (%)	59/84/27/2/4 (34/48/15/1/2)	14/26/6/1/3 (28/58/12/6/2)	45/58/21/1/1 (36/46/17/1/1)
PCI procedure
BMS/DES/POBA, n (%)	42/123/11 (24/70/6)	23/24/3 (46/48/6)*	19/99/8 (15/79/6)
Stent length of BMS or DES	22.0 ± 6.9	22.4 ± 5.8	21.9 ± 7.2
Stent size of BMS or DES	3.1 ± 0.4	3.2 ± 0.4*	3.0 ± 0.4

Table 1. Patient Characteristics at Baseline in All Patients and the ACS and SAP Groups

All patients

ACS

SAP

SAP: stable angina pectoris; ACS: acute coronary syndrome; BMI: body mass index; MI: myocardial infarction; CABG: coronary artery bypass graft; PCI: percutaneous coronary intervention; SBP: systolic blood pressure; DBP: diastolic blood pressure; DL: dyslipidemia; TG: triglyceride; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; DM: diabetes mellitus; HbA1c: hemoglobin A1c; LVEF: left ventricular ejection fraction; eGFR: estimated glomerular filtration rate; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker; OHA: oral hypoglycemic agent; RCA: right coronary artery; LAD: left anterior descending coronary artery; LCx: left circumflex coronary artery; LMT: left main trunk; BG: bypass graft; BMS: bare-metal stent; DES: drug-eluting stent; POBA: plain old balloon angioplasty. *P < 0.05, **P < 0.01 vs. SAP group.

No. of patients

176

126

Age, years

69 ± 11

68 ± 11

70 ± 11

Male, n (%)

143 (81)

43 (86)

100 (79)

BMI, kg/m²

24.0 ± 3.5

24.2 ± 3.5

24.0 ± 3.5

Smoking, %

106 (60)

30 (60)

76 (60)

Prior MI, n (%)

40 (23)

9 (18)

31 (25)

Prior PCI, n (%)

65 (37)

12 (24)*

53 (42)

Prior CABG, n (%)

13 (7)

5 (10)

8 (6)

SBP, mm Hg

130 ± 19

128 ± 22

131 ± 16

DBP, mm Hg

73 ± 14

76 ± 16

72 ± 13

DL, %

163 (93)

48 (96)

115 (91)

TG, mg/dL

133 ± 85

121 ± 74

138 ± 89

LDL-C, mg/dL

99 ± 31

103 ± 34

97 ± 30

HDL-C, mg/dL

46 ± 12

45 ± 11

47 ± 12

DM, %

69 (39)

17 (34)

52 (41)

HbA1c, %

6.3 ± 1.2

6.2 ± 1.3

6.3 ± 1.2

LVEF, %

60 ± 15

54 ± 16*

62 ± 14

eGFR

61 ± 21

65 ± 24

59 ± 20

Medications

ARB/ACE-I

147 (84)

44 (88)

103 (82)

CCB

131 (74)

32 (64)*

99 (79)

β-blocker

66 (38)

27 (54)**

39 (31)

Diuretics

34 (19)

12 (24)

22 (17)

Statin

155 (88)

45 (90)

110 (87)

Nitrate

118 (67)

28 (56)*

90 (78)

Nicorandil

30 (17)

9 (18)

21 (17)

OHA

43 (24)

13 (26)

30 (24)

Insulin

7 (4)

2 (4)

5 (4)

Target vessels of PCI

RCA/LAD/LCx/LMT/BG, n (%)

59/84/27/2/4 (34/48/15/1/2)

14/26/6/1/3 (28/58/12/6/2)

45/58/21/1/1 (36/46/17/1/1)

PCI procedure

BMS/DES/POBA, n (%)

42/123/11 (24/70/6)

23/24/3 (46/48/6)*

19/99/8 (15/79/6)

Stent length of BMS or DES

22.0 ± 6.9

22.4 ± 5.8

21.9 ± 7.2

Stent size of BMS or DES

3.1 ± 0.4

3.2 ± 0.4*

3.0 ± 0.4

**Table 2.** Clinical Outcomes in All Patients and the ACS and SAP Groups
	All patients	ACS	SAP
MACEs: major adverse cardiovascular events; MI: myocardial infarction; TLR: target lesion revascularization.
MACE, n (%)	19 (11)	7 (14)	12 (10)
MI, n (%)	6 (3)	3 (6)	3 (3)
TLR, n (%)	18 (10)	7 (14)	11 (9)
Death, n (%)	1 (0.6)	0 (0)	1 (0.8)

Table 2. Clinical Outcomes in All Patients and the ACS and SAP Groups

All patients

ACS

SAP

MACEs: major adverse cardiovascular events; MI: myocardial infarction; TLR: target lesion revascularization.

MACE, n (%)

19 (11)

7 (14)

12 (10)

MI, n (%)

6 (3)

3 (6)

3 (3)

TLR, n (%)

18 (10)

7 (14)

11 (9)

Death, n (%)

1 (0.6)

0 (0)

1 (0.8)

**Table 3.** Various BP Parameters in All Patients and the ACS and SAP Groups
	All patients	ACS	SAP
VVV: visit-to-visit variability; SBP: systolic blood pressure; DBP: diastolic blood pressure. *P < 0.05 vs. SAP.
VVV of SBP	10.2 ± 4.2	9.8 ± 4.9	10.3 ± 6.6
VVV of DBP	6.9 ± 4.4	6.7 ± 3.2	7.0 ± 4.8
Average of SBP, mm Hg	129 ± 13	125 ± 13*	130 ± 13
Average of DBP, mm Hg	73 ± 8	73 ± 9	73 ± 8
Maximum SBP, mm Hg	140 ± 17	136 ± 15*	141 ± 17
Maximum DBP, mm Hg	81 ± 11	80 ± 10	81 ± 12
Minimum SBP, mm Hg	117 ± 14	114 ± 15*	119 ± 13
Minimum DBP, mm Hg	70 ± 9	66 ± 9	66 ± 9

Table 3. Various BP Parameters in All Patients and the ACS and SAP Groups

All patients

ACS

SAP

VVV: visit-to-visit variability; SBP: systolic blood pressure; DBP: diastolic blood pressure. *P < 0.05 vs. SAP.

VVV of SBP

10.2 ± 4.2

9.8 ± 4.9

10.3 ± 6.6

VVV of DBP

6.9 ± 4.4

6.7 ± 3.2

7.0 ± 4.8

Average of SBP, mm Hg

129 ± 13

125 ± 13*

130 ± 13

Average of DBP, mm Hg

73 ± 8

73 ± 9

73 ± 8

Maximum SBP, mm Hg

140 ± 17

136 ± 15*

141 ± 17

Maximum DBP, mm Hg

81 ± 11

80 ± 10

81 ± 12

Minimum SBP, mm Hg

117 ± 14

114 ± 15*

119 ± 13

Minimum DBP, mm Hg

70 ± 9

66 ± 9

**Table 4.** Various BP Parameters in All Patients, Patients With or Without MACE, TLR and MI in the ACS and SAP Groups
	ACS	SAP
VVV: visit-to-visit variability; SBP: systolic blood pressure; DBP: diastolic blood pressure; PP: pulse pressure.
VVV of DBP, mm Hg	6.6 ± 3.3	7.5 ± 3.0	6.7 ± 3.3	6.4 ± 3.0	7.2 ± 4.8	5.1 ± 3.8	7.1 ± 4.8	4.5 ± 3.1
Average of SBP, mm Hg	124 ± 13	130 ± 9	125 ± 13	135 ± 12	130 ± 13	129 ± 17	130 ± 13	130 ± 1
Average of DBP, mm Hg	73 ± 9	75 ± 8	73 ± 9	82 ± 6	73 ± 8	74 ± 7	73 ± 8	76 ± 3
Maximum DBP, mm Hg	79 ± 10	82 ± 11	79 ± 10	87 ± 12	82 ± 12	79 ± 10	81 ± 12	81 ± 2
Minimum SBP, mm Hg	114 ± 15	117 ± 10	114 ± 15	119 ± 14	119 ± 13	118 ± 13	119 ± 13	121 ± 12
Minimum DBP, mm Hg	66 ± 10	66 ± 8	65 ± 9	74 ± 4	66 ± 9	67 ± 6	66 ± 9	71 ± 6

Table 4. Various BP Parameters in All Patients, Patients With or Without MACE, TLR and MI in the ACS and SAP Groups

ACS

SAP

MACE

(-)

(+)

(-)

(+)

(-)

(+)

(-)

(+)

VVV: visit-to-visit variability; SBP: systolic blood pressure; DBP: diastolic blood pressure; PP: pulse pressure.

VVV of DBP, mm Hg

6.6 ± 3.3

7.5 ± 3.0

6.7 ± 3.3

6.4 ± 3.0

7.2 ± 4.8

5.1 ± 3.8

7.1 ± 4.8

4.5 ± 3.1

Average of SBP, mm Hg

124 ± 13

130 ± 9

125 ± 13

135 ± 12

130 ± 13

129 ± 17

130 ± 13

130 ± 1

Average of DBP, mm Hg

73 ± 9

75 ± 8

73 ± 9

82 ± 6

73 ± 8

74 ± 7

73 ± 8

76 ± 3

Maximum DBP, mm Hg

79 ± 10

82 ± 11

79 ± 10

87 ± 12

82 ± 12

79 ± 10

81 ± 12

81 ± 2

Minimum SBP, mm Hg

114 ± 15

117 ± 10

114 ± 15

119 ± 14

119 ± 13

118 ± 13

119 ± 13

121 ± 12

Minimum DBP, mm Hg

66 ± 10

66 ± 8

65 ± 9

74 ± 4

66 ± 9

67 ± 6

66 ± 9

71 ± 6