Zhang Q, Zhou B, Ma Y, et al. - The results demonstrated that in patients with heart failure with preserved ejection fraction (HFpEF), high systolic blood pressure (SBP)-visit-to-visit variability (VVV) is correlated with an increased risk of adverse outcomes independent of the mean on-treatment SBP.

• Researchers recruited a sum of 1,988 patients (mean age of 67.73 ± 9.22, 51.7% female) from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist trial.

• They ascertained BP-VVV by the standard deviation (SD) of mean systolic BP (SBP-SD) from six measurements (baseline and months 1, 2, 4, 8, and 12) during the first 12 months after randomization.

• During the first 12 months, the mean on-treatment SBP was 127.77 ± 10.42 mmHg, and the median of SBP-SD was 8.15 mmHg.

• During the subsequent median follow-up of 35.16 months, a sum of 192 (9.7%) patients met the primary outcome, including a composite of cardiovascular death, heart failure hospitalization, or aborted cardiac arrest.

• Furthermore, Multiple Cox regression analysis demonstrated that SBP-SD was independently correlated with an elevated risk of the primary outcome after adjusting for age, gender, method of BP measurement, treatment, renal function, and common comorbidities, and the mean SBP during the first 12 months [hazard ratio (HR) for fourth vs. the first quartile, 1.63; 95% confidence interval (CI), 1.07–2.49; P = 0.024].

• It was shown that SBP-SD as a continuous variable was correlated with a 23% increase in the risk of the primary outcome (HR 1.23, 95% CI 1.06–1.43; P = 0.006).