To assess the prognostic value of variability in home-measured blood pressure (BP) and heart rate (HR) in a general population. Objective: Methods: BP and HR self-measurements were performed on 7 consecutive days. The variability of BP and HR were defined as the standard deviations (SDs) of morning minus evening, day-by-day, and first minus second measurements. The primary end point was incidence of cardiovascular events. The secondary end point was total mortality. Patients: 1866 Finnish adults aged years. Johansson JK et al. Hypertension. 2012;59:

VariableData (n=1866) Systolic home BP Diastolic home BP Home HR Age, y BMI, kg/m² Alcohol use, g/wk Male, % Smokers, % Antihypertensive medication, % Past history of cardiovascular disease, % Diabetes mellitus, % Hypercholesterolemia, % Sufficient physical activity, % (18.7) 80.1 (9.2) 68.3 (9.1) 56.4 (8.5) 27.4 (4.5) 78.2 (147.7) Values are expressed as mean (standard deviation [SD]) or percentages, as appropriate. BMI, body mass index; BP, blood pressure; HR, heart rate. Johansson JK et al. Hypertension. 2012;59:

VariableFatal and nonfatal CV events (n=179)* Total mortality (n=130)* RH (95 % CI)P P Systolic BP variability, mm HG -Morning-evening -Day-by-day -Morning day-by-day -Evening day-by-day -First minus second measurement HR variability, bpm -Morning-evening -Day-by-day -Morning day-by-day -Evening day-by-day -First minus second measurement 1.04 ( ) 1.02 ( ) 1.04 ( ) 1.02 ( ) 1.01 ( ) 1.07 ( ) 1.05 ( ) 1.11 ( ) 1.01 ( ) 1.02 ( ) < ( ) 1.05 ( ) 1.05 ( ) 1.04 ( ) 1.06 ( ) 1.08 ( ) 1.07 ( ) 1.11 ( ) 1.00 ( ) 1.03 ( ) < < BP, blood pressure; bpm, beats per minute; CI, confidence interval; CV, cardiovascular; HR, heart rate; RH, relative hazard. *Data were adjusted for age, sex, use of antihypertensive medication, diabetes mellitus, body mass index, history of CV disease, use of alcohol, smoking, presence of hypercholesterolemia, and degree of physical activity, as well as systolic and diastolic home BP or home HR level (average of 7-day duplicate morning and evening measurements). Johansson JK et al. Hypertension. 2012;59:

CONCLUSION The variabilities of home BP and HR are both predictive of CV events and mortality, therefore they should be used as additive information in the assessment of CV risk and treatments efficacy. Johansson JK et al. Hypertension. 2012;59: