ABSTRACT NUMBER: ESOC2026A2198 THE RELATIONSHIP BETWEEN ACHIEVED BLOOD PRESSURE AND BLOOD PRESSURE VARIABILITY WITH RECURRENT VASCULAR EVENTS IN THE CONVINCE TRIAL POPULATION

Abstract Background and aims Previous studies have proposed an association between BP variability (BPV) and recurrent stroke and major cardiovascular events (MACE) following ischaemic stroke. However, few recent data from large studies exist. We examined the association between mean BP and BPV during follow-up with recurrent vascular events and recurrent stroke in the CONVINCE trial, which randomized participants with recent non-cardioembolic ischaemic stroke to long term colchicine 0.5 mg daily or usual care. Methods Mean BP during follow-up was calculated using all available post-randomization BP readings recorded at six-monthly trial visits. Analysis of BPV was conducted for all participants with ≥3 BP readings during the first year of follow-up. BPV was measured as standard deviation (SD) and coefficient of variation (CV), adjusting for age, qualifying event, time from qualifying event to randomization and treatment group. Results Among 2919 participants with post-randomization BP readings, no association was observed between mean SBP or mean DBP during follow-up and recurrent vascular events or recurrent stroke. In 1629 participants who met pre-specified criteria for BPV analysis, on multivariate analysis of 174 events, each 10-point increase in SD of systolic BPV was associated with a one-fifth increased risk of MACE (adjusted HR 1.22, 95% CI 1.02-1.46, P = 0.032). Similar findings were observed for BPV measured as CV (adjusted HR 1.34, 95% CI 1.02-1.75, P = 0.035). There were no associations with recurrent stroke. Conclusions Significant associations existed between BPV and vascular events in the CONVINCE trial population, highlighting the importance of further investigation into BPV as a target for secondary prevention. Conflict of interest Pádraig Synnott: nothing to disclose.