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OS 37-06 VISIT-TO-VISIT VARIABILITY OF BLOOD PRESSURE AND RISK OF STROKE: RESULTS OF THE KAILUAN COHORT STUDY.

OBJECTIVE: The aim of this study was to prospectively explore the association between visit-to-visit variability of blood pressure (BP) and the risks of stroke and its subtypes.

DESIGN AND METHOD: A total of 57 927 participants from a Chinese urban community who have completed all 3 visits between 2006 and 2010 were included in this study. The variability of BP was defined as the coefficient of variation (CV) across 3 visits. Participants without BP information loss or a history of stroke event were then followed until the end of the study. The primary outcome was the first occurrence of stroke, which was diagnosed according to the World Health Organization criteria and classified into two main subtypes: ischemic and hemorrhage stroke.

RESULTS: Over a median of 3 years follow-up, we identified 582 first stroke cases, of which 489 (84.0%) were ischemic stroke, 94 (16.2%) were hemorrhagic stroke. After multivariable adjustment, including for mean BP, the hazard ratios (HR) (95% Confidence Intervals: CI) of comparing participants in the highest versus lowest quartile of CV of systolic blood pressure (SBP) was 1.44 (1.11, 1.87) for any stroke, 1.33 (1.00, 1.77) for ischemic stroke, 2.17 (1.09, 4.35) for hemorrhagic stroke. Similar results were also observed when CV of SBP was considered as a continuous exposure variable (per SD increase). Furthermore, higher variability of diastolic blood pressure (DBP) was also associated with hemorrhagic stroke but not ischemic stroke.

CONCLUSIONS: Higher visit-to-visit variability of BP might be an important objective to reduce stroke risk, especially for hemorrhagic stroke.

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