Blood Pressure Variability Linked to Mortality in Patients With ANCA-Associated Vasculitis

METHODOLOGY

• Researchers conducted a retrospective study to examine whether visit-to-visit BP variability predicts all-cause mortality in 95 patients with ANCA-associated vasculitis (mean age, 68 years; 51% men) receiving maintenance therapy at three Italian nephrology centres between 2001 and 2020.
• SBPV was calculated as the SD of at least four SBP readings, taken with a validated sphygmomanometer at baseline and every 3 months over a 12-month window that began a median of 11 months after diagnosis. Time-averaged SBP and pulse pressure — the mean of all readings over the same window — were also calculated.
• Patients were stratified into low (< 8 mm Hg), middle (8.1-12.5 mm Hg), and high (> 12.6 mm Hg) SBPV tertiles.
• The primary outcome was all-cause mortality over a median follow-up of 78 months.

RESULTS

• Over the follow-up period, 14.7% of patients with ANCA-associated vasculitis died, corresponding to an incidence rate of 30.5 events per 1000 patient-years.
• Each 5 mm Hg increase in SBPV was linked to an approximately twofold increased risk for death (hazard ratio, 2.03; P = .002); in contrast, average SBP over time did not differ significantly between those who died and survivors.
• Patients in the highest SBPV tertile had markedly worse survival than those in the two lower tertiles combined.
• After adjusting for age, sex, myeloperoxidase antibody status, estimated glomerular filtration rate, pulse pressure, and proteinuria, higher SBPV remained independently linked to the risk for all-cause mortality.

The study findings support the integration of BP variability assessment into long-term management strategies aimed at stabilizing BP and mitigating CV cardiovascular burden in AAV [antineutrophil cytoplasmic antibody-associated vasculitis.

 

https://www.medscape.com/viewarticle/blood-pressure-variability-linked-mortality-patients-anca-2026a10012al