Correlation between visit-to-visit and short-term blood pressure variability calculated using different methods and glomerular filtration rate



The aim of this study was to explore the correlation between visit-to-visit and short-term blood pressure variability (BPV), including systolic BPV (SBPV) and diastolic BPV (DBPV), calculated using different methods, and the glomerular filtration rate (GFR) in a late, middle-aged population. Using cluster sampling, we randomly selected retired employees of the Kailuan Group who were 60 years and participated in a third health examination for 24-h ambulatory blood pressure monitoring and inspection. Among the 3064 randomly selected observation subjects, 2464 were included based on the criteria. BPV was calculated using s.d., coefficient of variation (CV, s.d./Mean), variability independent of mean (VIM, s.d./Meanx) and BPV ratio (BPVR, s.d. (SBPV)/s.d. (DBPV)). Multivariate linear regression was used to analyse the correlation between estimated GFR (eGFR) and BPV calculated using different methods. The mean age of 2464 subjects was 67.4±6.1 years, with 1667 male subjects (67.7%). A total of 2104 cases were included in the visit-to-visit BPV group, and 1382 in the short-term BPV group. SBPV calculated using different methods showed statistically significant increasing trends for the SBP versus all s.d. and short-term BPVR. There was a significant, positive correlation between the visit-to-visit and short-term BPV calculated using different methods, which were all negatively correlated with eGFR (P<0.05). Multivariate linear regression analysis showed that, with correction for possible confounding factors, SBPV (24-h s.d., CV and VIM, and daytime CV and night time CV) and all DBPV demonstrated negative linear relationships with eGFR (P<0.05).

Access optionsAccess options

Rent or Buy article

Get time limited or full article access on ReadCube.


All prices are NET prices.

Figure 1


  1. 1

    Muntner P, Shimbo D, Tonelli M, Reynolds K, Arnett DK, Oparil S . The relationship between annual variability in systolic blood pressure and all-cause mortality in the general population: findings from NHANES III, 1988–1994. Hypertension 2011; 57 (2): 160–166.

  2. 2

    Rothwell PM, Howard SC, Dolan E, O’Brien E, Dobson JE, Dahlöf B et al. Prognostic significance of annual variability, maximum systolic blood pressure, and episodic hypertension. Lancet 2010; 375 (9718): 895–905.

  3. 3

    Gavish B, Ben-Dov IZ, Kark JD, Mekler J, Bursztyn M . The association of a simple blood pressure-independent parameter derived from ambulatory blood pressure variability with short-term mortality. Hypertens Res 2009; 32 (6): 488–495.

  4. 4

    Veerman DP, de Blok K, vnn Montfrans A . Relationship of steady state and ambulatory blood pressure variability to left ventricular mass and urinary albumin excretion in essential hypertension. Am J Hypertens 1996; 9 (5): 455–460.

  5. 5

    Manios E, Tsagalis G, Tsivgoulis G, Barlas G, Koroboki E, Michas F et al. Time rate of blood pressure variation is associated with impaired renal function in hypertensive patients. J Hypertens 2009; 27 (11): 2244–2248.

  6. 6

    Wu SL, Huang ZR, Yang XC, Zhou Y, Wang AX, Chen L et al. Prevalence of ideal cardiovascular health and its relationship with the 4-year cardiovascular events in a northern Chinese industrial city. Circ Cardiovasc Qual Outcomes 2012; 5 (4): 487–493.

  7. 7

    Farhan H, Al M . Comparative study of ambulatory blood pressure monitoring and clinic blood pressure measurement in the risk assessment and management of hypertension. Sultan Qaboos Univ Med J 2010; 10 (3): 370–376.

  8. 8

    Su C, Zhang GX, Wang RF, Yuan L, Zhang JJ, Wang XR et al. Application of the CKD-EPI equation for estimation of glomerular filtration rate in Chinese patients with chronic kidney disease. Chin J Dis Control Prev 2013; 17 (7): 621–624.

  9. 9

    Okada H, Fukui M, Tanaka M, Inada S, Mineoka Y, Nakanishi N et al. Annual variability in systolic blood pressure is correlated with diabetic nephropathy and atherosclerosis in patients with type 2 diabetes. Atherosclerosis 2012; 220 (1): 155–159.

  10. 10

    Hata J, Arima H, Rothwell PM, Woodward M, Zounqas S, Anderson C et al. Effects of annual variability in systolic blood pressure on macrovascular and microvascular complications in patients with type 2 diabetes mellitus: the ADVANCE trial. Circulation 2013; 128 (12): 1325–1334.

  11. 11

    Kawai T, Ohishi M, Kamide K, Nakama C, Onishi M, Ito N et al. Differences between daytime and nighttime blood pressure variability regarding systemic atherosclerotic change and renal function. Hypertens Res 2013; 36 (3): 232–239.

  12. 12

    Narkiewicz K, Winnicki M, Schroeder K, Phillips BG, Kato M, Cwalina E et al. Relationship between muscle sympathetic nerve activity and diurnal blood pressure profile. Hypertension 2002; 39 (1): 168–172.

  13. 13

    Kawai T, Ohishi M, Ito N, Onishi M, Takeya Y, Yamamoto K et al. Alteration of vascular function is an important factor in the correlation between annual blood pressure variability and cardiovascular disease. J Hypertens 2013; 31 (7): 1387–1395.

  14. 14

    Yokota K, Fukuda M, Matsui Y, Hoshide S, Shimada K, Kario K . Impact of annual variability of blood pressure on deterioration of renal function in patients with nondiabetic chronic kidney disease. Hypertens Res 2013; 36 (2): 151–157.

  15. 15

    Grassi G, Quarti-Trevano F, Seravalle G, Arenare F, Volpe M, Furiani S et al. Early sympathetic activation in the initial clinical stages of chronic renal failure. Hypertension 2011; 57 (4): 846–851.

  16. 16

    Su DF, Miao CY . Blood pressure variability and organ damage. Clin Exp Pharmacol Physiol 2001; 28 (9): 709–715.

  17. 17

    Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M et al. ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34 (28): 2159–2219.

Download references


We thank all participants and staff of the Kailuan study for their important contributions.

Author information

Correspondence to F Wang or S Wu.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on the Journal of Human Hypertension website

Supplementary information

Supplementary Information (DOCX 13 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Further reading