Relationship Between Blood Pressure Variability and Heart Failure in UAP Patients with High Blood Pressure

ZHANG Ning; MIAO Dandan; JIN Yu; CHAI Jianwen

doi:10.12102/j.issn.1672-1349.2025.04.018

Abstract：Objective: To investigate the clinical relationship between blood pressure variability (BPV) and the development of heart failure in patients with unstable angina pectoris (UAP) and hypertension. Methods: A total of 107 patients with UAP and hypertension (observation group) and 107 patients with UAP without hypertension (UAP group) were enrolled, along with 107 healthy volunteers as the control group. Ambulatory blood pressure monitoring was used to record and compare BPV-related indicators, including daytime and nighttime systolic blood pressure variability (SSD) and diastolic blood pressure variability (DSD), as well as 24-hour SSD and DSD. After a one-year follow-up, the incidence of heart failure was recorded in the observation group and the UAP group. According to whether heart failure occurred, the observation group was divided into the occurrence group and the non-occurrence group. The general data and BPV of the two groups were compared. Logistic regression analysis was used to explore the factors influencing the development of heart failure in the observation group. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of individual and combined BPV-related indicators for heart failure in the observation group. Results: The daytime systolic blood pressure variability (dSSD), daytime diastolic blood pressure variability (dDSD), nighttime systolic blood pressure variability (nSSD), nighttime diastolic blood pressure variability (nDSD), 24-hour systolic blood pressure variability (24 h SSD), and 24-hour diastolic blood pressure variability (24 h DSD) in the observation group were higher than those in the UAP group and the control group (P < 0.05). There was no statistically significant difference in dSSD, dDSD, nSSD, nDSD, 24 h SSD, and 24 h DSD between the UAP group and the control group (P > 0.05). The incidence of heart failure in the observation group was higher than that in the UAP group (P < 0.05). Gensini score, dSSD, dDSD, nSSD, nDSD, 24 h SSD, and 24 h DSD were all risk factors for heart failure in patients with UAP and hypertension (OR values were 2.779, 3.522, 5.697, 3.804, 3.274, 3.483, and 4.284, respectively; P < 0.05). The sensitivity of combined prediction using dSSD, dDSD, nSSD, nDSD, 24 h SSD, and 24 h DSD was higher than that of individual prediction (P < 0.01), and the area under the ROC curve (AUC) was also higher (P < 0.05), while the specificity showed no statistically significant difference compared to individual prediction (P > 0.05). Conclusion: BPV is a risk factor for the development of heart failure in patients with UAP and hypertension. The combined prediction of dSSD, dDSD, nSSD, nDSD, 24 h SSD, and 24 h DSD has better performance than individual prediction.