Risk Factor Variability and Cardiovascular Outcome: JACC Review Topic of the Week

Until recently, intraindividual visit-to-visit variability of cardiovascular risk factors has been dismissed as random fluctuation. This simplistic concept was challenged by demonstrating that visit-to-visit blood pressure variability, independent of average blood pressure, was a powerful risk facto...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2019-05, Vol.73 (20), p.2596-2603
Main Authors: Messerli, Franz H, Hofstetter, Louis, Rimoldi, Stefano F, Rexhaj, Emrush, Bangalore, Sripal
Format: Article
Language:English
Subjects:
Blood glucose
Blood pressure
Body weight
Cardiology
Cardiovascular disease
Cardiovascular diseases
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - physiopathology
Cause of Death - trends
Cholesterol
Congestive heart failure
Coronary artery
Coronary artery disease
Dementia disorders
End-stage renal disease
Health risk assessment
Health risks
Heart attacks
Heart rate
Hemodynamics - physiology
Humans
Kidney diseases
Morbidity - trends
Mortality
Periodicals as Topic
Renal failure
Risk analysis
Risk Assessment - methods
Risk Factors
Survival Rate - trends
United States - epidemiology
Variability
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Summary:Until recently, intraindividual visit-to-visit variability of cardiovascular risk factors has been dismissed as random fluctuation. This simplistic concept was challenged by demonstrating that visit-to-visit blood pressure variability, independent of average blood pressure, was a powerful risk factor for stroke. Subsequently, variability of other cardiovascular risk factors such as cholesterol, glycemia, and body weight was documented to increase risk independent of their absolute values. Variability of these risk factors has been demonstrated to be a powerful predictor for all-cause and cardiovascular mortality, stroke, coronary artery disease, heart failure, end-stage renal disease, and dementia. With the notable exception of heart rate, cardiovascular risk factors must now be defined by 2 components: the magnitude and duration of sustained risk factor elevation and, equally important, the variability of the same risk factor over time.
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2019.02.063