Abstract: Objective To explore the correlation between blood pressure variability and adverse cardiovascular events in the elderly hypertensive patients. Methods A total of 182 elderly hypertensive patients admitted to Xianyang Hospital, Yan’an University from August 2022 to March 2023 were selected, and were followed uptill June 1, 2024, and the patients were divided into adverse cardiovascular event group and non-event group based on whether they presented with adverse cardiovascular events. Blood pressure levels were monitored using a non-invasive portable ambulatory blood pressure monitor, and blood pressure variability was assessed using the average real variation (ARV). The correlation between blood pressure variability and adverse cardiovascular events was analyzed using Point-biserial correlation analysis, and a multivariate logistic regression analysis was conducted. Results At the end of the last follow-up, a total of 10 cases were lost to follow-up, and 172 cases were finally included in the study. A total of 39 cases presented with the endpoint events and were classified as the adverse cardiovascular event group, while the other 133 cases were enrolled in the non-event group. There were significant differences in 24 h mean systolic blood pressure (24hSBP), 24 h mean diastolic blood pressure (24hDBP), night mean systolic blood pressure (nSBP), night mean diastolic blood pressure (nDBP), 24 h systolic blood pressure variability (24hSBPV), 24 h mean diastolic blood pressure variability (24hDBPV), day mean systolic blood pressure variability (dSBPV), day mean diastolic pressure variability (dDBPV), mean nocturnal systolic pressure variability (nSBPV) and mean nocturnal diastolic pressure variability (nDBPV) between the two groups(P<0.05).Point-biserial correlation analysis showed that 24hSBP, dSBP, nSBP, nDBP, 24hSBPV, 24hDBPV, dSBPV, dDBPV, nSBPV, nDBPV were positively correlated with the adverse cardiovascular events in the elderly hypertensive patients (P<0.05). Logistic regression analysis showed that nSBP (OR=1.129,95%CI: 1.050－1.215), nDBP (OR=1.150,95%CI: 1.021－1.294), nSBPV (OR=1.895,95%CI: 1.327－2.706) and nDBPV (OR=4.746,95%CI: 2.232－10.090) were independent risk factors for adverse cardiovascular events in the elderly patients with hypertension. Conclusions Nocturnal blood pressure variability is correlated with adverse cardiovascular events in the elderly hypertensive patients. Monitoring nocturnal blood pressure variability can provide a basis for predicting adverse cardiovascular events in the elderly hypertensive patients.

Key words: nocturnal blood pressure, blood pressure variability, hypertension, cardiovascular event, correlation