RELATIONSHIP BETWEEN BLOOD PRESSURE MONITORING DATA AND MORTALITY ACCORDING TO THE HOSPITAL REGISTRY

Objective: Currently, the 24-h blood pressure monitoring (BPM) is often being performed in hospital conditions in patients with comorbidities, but prognostic value of these data is unclear. The aim of our study to evaluate the prognostic value of BPM results, obtained in hospitalized patients. Design and method: In a retro-prospective study based on the hospital registry of NMRC TPM, 358 patients who underwent an inpatient treatment in 2013-2015 were included into the final analysis. The inclusion criteria: permanent residence in Moscow, arterial hypertension (AH), valid BPM at the hospital stage (at least 15 measurements during the day and 3 at night), informed consent, absence of atrial fibrillation or flutter in the anamnesis. All participants were contacted by phone after 8-10 years of the reference hospitalization to establish their vital status. The statistical methods included ANOVA and survival analysis. Results: The mean age at the hospitalization stage (M±SD) was 72.9±12.0 (min - 25 years, max - 97 years), the percent of male patients - 31.0%; 77 patients died (mean age at the time of hospitalization 82.1±9.9, 20.8% males). Because of the differences in the age groups (<75 / =>75 years), mortality factors in the respective groups were analyzed separately. In the 18-74 years group (n=197), the overall mortality was jointly related with cardiovascular (CV) comorbidity (HR=3.25; 95% CI=1.14-9.22; p=0.027), the average real variability (HR=1.19; 95% CI=1.01-1.41; p=0.038) and the mean daily pulse BP (HR=1.05; 95% CI=1.02-1.09; p=0.002). There was no association with gender, age and antihypertensive therapy. In the group of patients older than 75 years (n=161), mortality was associated with age (HR=1.174; 95% CI=1.116-1.234; p<0.001) and wasn’t related to sex, BPM data, antihypertensive therapy and CV comorbidity. Conclusions: We found the prognostic value of mean BP and its variability in patients younger than 75 year. The practicability of hospital BP monitoring in older patients needs further investigation.