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However, studies have not fully explored this association in patients with heart failure with preserved ejection fraction (HFpEF). This study sought to explore the association between visit-to-visit variability (VVV) of BP and clinical outcomes in patients with HFpEF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>A total of 1988 patients (mean age of 67.73 \u00b1 9.22, 51.7% female) from the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial were included in this study. BP-VVV was determined by standard deviation (SD) of mean systolic BP (SBP-SD) from six measurements (baseline and months 1, 2, 4, 8, and 12) during the first 12 months after randomization. Mean on-treatment SBP during the first 12 months was 127.77 \u00b1 10.42 mmHg, and the median of SBP-SD was 8.15 mmHg. A total of 192 (9.7%) patients met the primary outcome during the subsequent median follow-up of 35.16 months, including a composite of cardiovascular death, heart failure hospitalization, or aborted cardiac arrest. Multiple Cox regression analysis showed that SBP-SD was independently associated with the increased risk of the primary outcome after adjusting for age, gender, method of BP measurement, treatment, renal function and common co-morbidities, and the mean SBP during the first 12 months [hazard ratio (HR) for fourth vs. first quartile, 1.63; 95% confidence interval (CI), 1.07\u20132.49; P = 0.024]. Analysis showed that SBP-SD as continuous variable was associated with a 23% increase in the risk of primary outcome (HR 1.23, 95% CI 1.06\u20131.43; P = 0.006).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The findings of the current study show that high SBP-VVV in patients with HFpEF is associated with an increased risk of adverse outcomes independent of the mean on-treatment SBP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13542","type":"journal-article","created":{"date-parts":[[2021,8,18]],"date-time":"2021-08-18T05:26:31Z","timestamp":1629264391000},"page":"3984-3996","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Blood Pressure Visit-to-Visit Variability and Outcomes in Patients with Heart Failure with Preserved Ejection Fraction"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8437-8531","authenticated-orcid":false,"given":"Qi","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Cardiology, Tianjin Chest Hospital , #261 Taierzhuangnan Road, Jinnan District, Tianjin ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bingyang","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Chest Hospital , #261 Taierzhuangnan Road, Jinnan District, Tianjin ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Chest Hospital , #261 Taierzhuangnan Road, Jinnan District, Tianjin ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuecheng","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Chest Hospital , #261 Taierzhuangnan Road, Jinnan District, Tianjin ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4287-3152","authenticated-orcid":false,"given":"Ximing","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Chest Hospital , #261 Taierzhuangnan Road, Jinnan District, Tianjin ,","place":["China"]},{"name":"Tianjin Medical University , Tianjin ,","place":["China"]},{"name":"Chest Hospital, Tianjin University , Tianjin ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1250-0398","authenticated-orcid":false,"given":"Hongliang","family":"Cong","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tianjin Chest Hospital , #261 Taierzhuangnan Road, Jinnan District, Tianjin ,","place":["China"]},{"name":"Tianjin Medical University , Tianjin 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