@article {
    orvium-67060df82ef2756e59c94341,
    title = "24-Hour Blood Pressure Variability Assessed by Average Real Variability: A Systematic Review and Meta-Analysis",
    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<0.05)
after adjustment for BP and other clinical factors. In addition, increased ARV in systolic BP was associated with risk of all
cardiovascular events (hazard ratio, 1.18; 95% confidence interval, 1.09–1.27). Only 2 cross-sectional studies did not find that high
ARV was a significant risk factor.
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.",
    keywords = "blood pressure variability, cardiovascular events, target organ damage",
    author = "Luis J. Mena",
    year = "2024",
    doi = "10.1161/JAHA.117.006895",
    language = "English",
    url = "https://dapp.orvium.io/deposits/67060df82ef2756e59c94341/view",
}