Ps-c12-2: visit-to-visit blood pressure variability and clinical events in older patients receiving home medical care: the ohcare study

Aim: We investigated the associations of visit-to-visit variability(VVV) of blood pressure (BP) with clinical events (death, hospitalization, falling) in older patient around 85 years old receiving home medical care. Methods: This study was performed in OHCARE (Osaka Home CAre REgistry), which is a prospective cohort study targeted old patients receiving home-based medical care in Japan. There were 103 eligible patients fulfilling the inclusion criteria: aged 65 years or older; BP measurements at least three occasions before the baseline date (median 4.78 occasions); BP measurement interval in 16 ± 13 days (median ± 1SD). We used the standard deviation (SD), Coefficient of variation (CV) of SBP measured at baseline as the VVV of BP. Main outcomes were clinical events including hospitalizations, falling and death during follow-up period. Results: It was clarified that VVV of BP was exists in older patients receiving home medical care (10.7 / 7.2 mmHg). Regarding the relationship between VVV and clinical events during follow-up, the rate of hospitalization was significantly higher in the group with the largest SBP-SD than in the group with the smallest. Furthermore, multivariate analysis adjusted by age, sex, ADL and current diseases showed that SD and CV of SBP were independent positive association of hospitalization events. Conclusion: In older patients with frailty requiring home medical care, a higher VVV in SBP may be related to the occurrence of events leading hospitalizations. Furthermore, higher VVV in SBP could be a predictive marker of clinical events leading to hospitalization.