Relationship Between 24-hour Blood Pressure Variability and FRagility in the Elderly Patient

NCT05818280 | Completed

• 1 other identifier: 2022PI197
• Study Type: observational
• Target: 49
• Locations: 1 country
• Sites: 1

Brief Summary

In the 2016's Haute Autorité de Santé (HAS) recommendations (Haute Autorité de Santé. Management of arterial hypertension in adults. Saint-Denis La Plaine: HAS; 2016.) concerning the management of arterial hypertension in adults, the Ambulatory Blood Pressure Measurement (ABPM) is described as a diagnostic tool for hypertension as well as a tool useful for checking blood pressure (BP) control in treated patients. It is also stipulated that ABPM can provide additional information such as the exploration of significant blood pressure variability. The 2014's ESH recommendations (ESH practical guidelines for ambulatory blood pressure monitoring, 2014) concerning ABPM indicate that variability of BP over 24 hours can be considered as a research parameter. Blood Pressure Variability could be a better predictor of organ damage related to hypertension than blood pressure measured in consultation. Furthermore, BP measurement over 24 hours has been demonstrated as a more sensitive risk factor for cardiovascular events such as stroke or ischemic coronary events. It is specified in the 2018 ESH/ESC guidelines on the management of hypertension (Mancia G, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. 2018) that an additional number of ABPM parameters may have prognostic value such as 24-hour variability even if there is no indication yet of its evaluation in clinical routine. The variability of blood pressure is associated with an increased risk of cardiovascular events, in particular stroke and coronary events in young and hypertensive patients, regardless of their cardiovascular risk factors, mean value of their systolic BP measured in ABPM or during consultation follow-up as shown by Rothwell PM et al. (Prognostic significance of visit-to-visit variability, maximum systolic blood pressure, and episodic hypertension. The Lancet. mars 2010;375(9718):895-905) and Mehlum MH et al. (Blood pressure variability and risk of cardiovascular events and death in patients with hypertension and different baseline risks. Eur Heart J. 21 juin 2018;39(24):2243-51.) Studies also show that BP variability in elderly hypertensive patients is an independent risk factor for cardiovascular events (Eto M et al. Impact of Blood Pressure Variability on Cardiovascular Events in Elderly Patients with Hypertension. Hypertens Res. 2005;28(1):1-7.) and that BP variability would be greater in the elderly patient (Magdás A et al. Ambulatory monitoring derived blood pressure variability and cardiovascular risk factors in elderly hypertensive patients. Biomed Mater Eng. 2014;24(6):2563-9) Finally, a link between frailty and blood pressure variability is demonstrated by Rouch L et al. (Visit-to-Visit Blood Pressure Variability and Incident Frailty in Older Adults. Le Couteur D, éditeur. J Gerontol Ser A. 13 juill 2021;76(8):1369-75.) However, BP variability, measured in this study by blood pressure variation between clinical visits, does not assess overnight variability. Another limitation in the evaluation of frailty is the exclusion of patients with an MMSE \< 24. Hussain SM et al. (Variation in Mean Arterial Pressure Increases Falls Risk in Elderly Physically Frail and Prefrail Individuals Treated With Antihypertensive Medication. Hypertension. sept 2022;79(9):2051-61.) also show that BP variability measured by ABPM would increase the risk of serious falls in frail or pre-frail elderly subjects taking antihypertensive treatment. The objective of this study is therefore to evaluate the link between blood pressure variability on 24-hour recordings measured by the standard deviation and the coefficient of variation, according to the frailty status in patients aged over 75 with hypertension, treated or not with antihypertensive molecules.

Conditions

Hypertension

Keywords

Hypertension; Frail patient

Outcome Measures

Primary Outcomes (1)

• Standard deviation of 24 hours Systolic Arterial blood pressure

  Assessed on 24-hour Arterial Blood Pressure Measurement (ABPM)

  From inclusion until 24 hours

Secondary Outcomes (7)

• Coefficient of variation of 24 hours systolic Arterial blood pressure

  From inclusion until 24 hours

• Standard deviation of 24 hours Diastolic Arterial blood pressure

  From inclusion until 24 hours

• Standard deviation of 24 hours Pulse arterial blood pressure

  From inclusion until 24 hours

• Standard deviation of 24 hours Mean arterial blood pressure

  From inclusion until 24 hours

• Coefficient of variation of 24 hours Diastolic Arterial blood pressure

  From inclusion until 24 hours

Eligibility Criteria

• Age: 75 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Patients over 75 years old, admitted for consultation or day hospitalisation in the Geriatric Service of the CHRU, living at home, with treated or untreated hypertension with clinical indication for an ABPM and Clinical indication for a frailty measurement

You may qualify if:

• Patients over 75 years old, men and women,
• Patients admitted for consultation or day hospitalisation to the Geriatric Service of the CHRU, living at home, with treated or untreated hypertension with :
• Clinical indication for an ABPM
• Clinical indication for a frailty measurement

You may not qualify if:

• Opposition to the use of data
• Inability to perform ABPM

Sponsors & Collaborators

• Pr. Nicolas GIRERD: lead

Study Sites (1)

CHRU de NANCY

Vandœuvre-lès-Nancy, 54500, France

Location

MeSH Terms

Conditions

Hypertension

Condition Hierarchy (Ancestors)

Vascular Diseases; Cardiovascular Diseases

Study Officials

• Nicolas GIRERD, MD-PhD

  CHRU de NANCY

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Study chair

Study Record Dates

• First Submitted: April 4, 2023
• First Posted: April 18, 2023
• Study Start: January 12, 2023
• Primary Completion: August 29, 2024
• Study Completion: August 29, 2024
• Last Updated: June 19, 2025

Record last verified: 2025-06

Data Sharing

• IPD Sharing: Will not share

Locations

FR (1)