{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T21:22:57Z","timestamp":1790630577934,"version":"4.1.0"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,7,8]],"date-time":"2021-07-08T00:00:00Z","timestamp":1625702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"NIH","doi-asserted-by":"publisher","award":["K23NS105924"],"award-info":[{"award-number":["K23NS105924"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000065","name":"NINDS","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000065","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009857","name":"Regeneron Pharmaceuticals","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009857","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Studies demonstrate an association between visit-to-visit blood pressure variability (BPV) and cardiovascular events and death. We aimed to determine the long-term cardiovascular and mortality effects of BPV in midlife in participants with and without cardiovascular risk factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS<\/jats:title>\n                  <jats:p>This is a post-hoc analysis of the Atherosclerosis Risk in the Community study. Long-term BPV was derived utilizing mean systolic blood pressure at Visits 1\u20134 (Visit 1: 1987\u20131989, Visit 2: 1990\u20131992, Visit 3: 1993\u20131995, Visit 4: 1996\u20131998). The primary outcome was mortality from Visit 4 to 2016 and secondary outcome was cardiovascular events (fatal coronary heart disease, myocardial infarction, cardiac procedure, or stroke). We fit Cox proportional hazards models and also performed the analysis in a subgroup of cardiovascular disease-free patients without prior stroke, myocardial infarction, congestive heart failure, hypertension, or diabetes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>We included 9,578 participants. The mean age at the beginning of follow-up was 62.9 \u00b1 5.7 years, and mean follow-up was 14.2 \u00b1 4.5 years. During follow-up, 3,712 (38.8%) participants died and 1,721 (n = 8,771, 19.6%) had cardiovascular events. For every SD higher in systolic residual SD (range 0\u201360.5 mm Hg, SD = 5.6 mm Hg), the hazard ratio for death was 1.09 (95% confidence interval [CI] 1.05\u20131.12) and for cardiovascular events was 1.00 (95% CI 0.95\u20131.05). In cardiovascular disease-free participants (n = 4,452), the corresponding hazard ratio for death was 1.12 (95% CI 1.03\u20131.21) and for cardiovascular events was 1.01 (95% CI 0.89\u20131.14).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSION<\/jats:title>\n                  <jats:p>Long-term BPV during midlife is an independent predictor of later life mortality but not cardiovascular events.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpab106","type":"journal-article","created":{"date-parts":[[2021,7,7]],"date-time":"2021-07-07T19:28:23Z","timestamp":1625686103000},"page":"1269-1275","source":"Crossref","is-referenced-by-count":13,"title":["Midlife Blood Pressure Variability and Risk of All-Cause Mortality and Cardiovascular Events During Extended Follow-up"],"prefix":"10.1093","volume":"34","author":[{"given":"Adam","family":"de Havenon","sequence":"first","affiliation":[{"name":"Department of Neurology, University of Utah , Salt Lake City, Utah , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alen","family":"Delic","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Utah , Salt Lake City, Utah , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shadi","family":"Yaghi","sequence":"additional","affiliation":[{"name":"Department of Neurology, New York University , New York, New York , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ka-Ho","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Utah , Salt Lake City, Utah , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer J","family":"Majersik","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Utah , Salt Lake City, Utah , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Stulberg","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Utah , Salt Lake City, Utah , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Tirschwell","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington , Seattle, Washington , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7813-2949","authenticated-orcid":false,"given":"Mohammad","family":"Anadani","sequence":"additional","affiliation":[{"name":"Department of Neurology, Washington University in St. Louis , St. Louis, Missouri , 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