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Abstract: FR-PO376

High Variability of Initial 24-Hour Systolic Blood Pressure After ICU Admission Is Associated with Mortality

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Kwon, Soon hyo, Soonchunhyang University, Seoul, Korea (the Republic of)
  • Park, Moo Yong, Soonchunhyang University Hospital, Seoul, Korea (the Republic of)
  • Kim, Hyoungnae, Soonchunhyang University Hospital, Seoul, Korea (the Republic of)
  • Noh, Hyunjin, Soonchunhyang University Hospital, Seoul, Korea (the Republic of)
Background

Increased blood pressure variability predicts long-term outcomes in cardiovascular and kidney disease. This study aimed to determine whether variability of initial 24-hour systolic blood pressure (SBP) affects mortality in critically ill patients.

Methods

In a retrospective study, we enrolled patients who had been admitted to 2 adult intensive care units (ICU) in a single center between Nov. 2015 and Oct. 2017. All patients were under active treatment. Variability of patients’ blood pressure was assessed by initial 24-hour SBP coefficient of variation (CV) after ICU admission. CV was measured as standard deviation of SBP divided by mean of SBP. Patients were categorized into two groups based on SBP CV. The effect of SBP variability on 90 day mortality was analyzed.

Results

Of the 451 patients (male 56 %) were analyzed, 25.7% of patients died within 90 days. The mean SBP CV was 7.6 ± 1.4 % in low CV group (n=225) and 13.6 ± 3.2 % in high CV group (n=226). In Kaplan-Meier survival analysis, 90 day mortality of high CV group was higher than that of low CV group (p = 0.001) (Figure 1). A Cox analysis showed that high CV in SBP was an independent risk factor for death compared to low CV in SBP (HR 1.87; 95% CI, 1.26-2.77; p = 0.002) after adjust of age, sex, comorbidities, inotropic agents and SBP.

Conclusion

Higher SBP variability in critically ill patients was associated with high mortality. This suggests that variability of blood pressure would be helpful for prediction of prognosis and treatment in ICU patients.

Funding

  • Government Support - Non-U.S.