Blood pressure variability with different measurement methods

Giorno, Rosaria Del; Balestra, L; Heiniger, P.S; Gabutti, Luca

doi:10.1097/md.0000000000016347

Cited by 35 publications

(25 citation statements)

References 34 publications

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“…Interestingly, in multivariable analysis, VIM of SBP showed a strong, negative linear relationship with TAC, independent of average SBP and DBP levels. Moreover, another study conducted on hospitalized elderly individuals with HTN has confirmed a positive correlation between the amplitude of beat-to-beat BP fluctuations, as assessed by ΔBP (the difference between maximum and minimum BP values), and vascular stiffness expressed by pulse wave velocity (PWV) [41]; large BP fluctuations were associated with lower vascular elasticity.…”

Section: Introductionmentioning

confidence: 83%

“…Hence, the direct positive impact of lacidipine on effectors of beat-to-beat BPV was demonstrated [49]. A clinical study on elderly hypertensive individuals further confirmed the ameliorative effect of CCBs by showing a tendency for beat-to-beat SBPV to decrease with their use, although it increases with the use of diuretics [41]. A study on a normotensive rat model with increased beat-to-beat BPV revealed the presence of pleotropic effects specific to drug generations.…”

Section: Introductionmentioning

confidence: 88%

“…The recognized prognostic value of beat-to-beat BPV led researchers to characterize it not only in patients diagnosed with hypertension [12,41] but also in individuals at high-risk of developing it in an attempt to investigate early changes in BP dynamics and identify a possible heritable character [47,48]. For instance, Wu et al [48] compared BPV responses to CPT in offspring of normotensive (ONP) and hypertensive parents (OHP).…”

Section: Linear Beat-to-beat Blood Pressure Variability Parameters In...mentioning

confidence: 99%

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Beat-to-beat blood pressure variability: an early predictor of disease and cardiovascular risk

Bakkar

El‐Yazbi

Zouein

et al. 2021

Journal of Hypertension

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Blood pressure (BP) varies on the long, short and very-short term. Owing to the hidden physiological and pathological information present in BP time-series, increasing interest has been given to the study of continuous, beat-to-beat BP variability (BPV) using invasive and noninvasive methods. Different linear and nonlinear parameters of variability are employed in the characterization of BP signals in health and disease. Although linear parameters of beat-to-beat BPV are mainly measures of dispersion, such as standard deviation (SD), nonlinear parameters of BPV quantify the degree of complexity/irregularity-using measures of entropy or self-similarity/correlation. In this review, we summarize the value of linear and nonlinear parameters in reflecting different information about the pathophysiology of changes in beat-to-beat BPV independent of or superior to mean BP. We then provide a comparison of the relative power of linear and nonlinear parameters of beat-to-beat BPV in detecting early and subtle differences in various states. The practical advantage and utility of beat-to-beat BPV monitoring support its incorporation into routine clinical practices.

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Section: Introductionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 88%

Section: Linear Beat-to-beat Blood Pressure Variability Parameters In...mentioning

confidence: 99%

See 1 more Smart Citation

Beat-to-beat blood pressure variability: an early predictor of disease and cardiovascular risk

Bakkar

El‐Yazbi

Zouein

et al. 2021

Journal of Hypertension

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Section: Discussionmentioning

confidence: 99%

“…The use of the former is conceptionally more intuitive while the latter may be considered more robust because, by dividing within patient SD by their mean, a degree of random variation can be overcome. 25 Importantly, these 2 measures are suitable to measure blood pressure variability in the context that clinic and 24-hour BPs were collected in this trial, whereas variation independent of the mean and the average real variability are less suitable in the context of limited clinic measures. Furthermore, the trends in BP variability across the 3 groups of patients were similar whether measured by SD or coefficient of variation.…”

Section: Discussionmentioning

confidence: 99%

Effect of 3, 2-Drug Combinations of Antihypertensive Therapies on Blood Pressure Variability in Black African Patients: Secondary Analyses of the CREOLE Trial

et al. 2022

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Background: The effect of 3 commonly recommended combinations of anti-hypertensive agents—amlodipine plus hydrochlorothiazide (calcium channel blocker [CCB]+thiazide), amlodipine plus perindopril (CCB+ACE [angiotensin-converting enzyme]-inhibitor), and perindopril plus hydrochlorothiazide (ACE-inhibitor+thiazide) on blood pressure variability (V) are unknown. Methods: We calculated the blood pressure variability (BPV) in 405 patients (130, 146, and 129 randomized to ACE-inhibitor+thiazide, CCB+thiazide, and CCB+ACE-inhibitor, respectively) who underwent ambulatory blood pressure monitoring after 6 months of treatment in the Comparisons of Three Combinations Therapies in Lowering Blood Pressure in Black Africans trial (CREOLE) of Black African patients. BPV was calculated using the SD of 30-minute interval values for 24-hour ambulatory BPs and for confirmation using the coefficient of variation. Linear mixed model regression was used to calculate mean differences in BPV between treatment arms. Within-clinic BPV was also calculated from the mean SD and coefficient of variation of 3 readings at clinic visits. Results: Baseline distributions of age, sex, and blood pressure parameters were similar across treatment groups. Participants were predominately male (62.2%) with mean age 50.4 years. Those taking CCB+thiazide had significantly reduced ambulatory systolic and diastolic BPV compared with those taking ACE-inhibitor+thiazide. The CCB+thiazide and CCB+ACE-inhibitor groups showed similar BPV. Similar patterns of BPV were apparent among groups using within-clinic blood pressures and when assessed by coefficient of variation. Conclusions: Compared with CCB-containing combinations, ACE-inhibitor plus thiazide was associated with higher levels, generally significant, of ambulatory and within-clinic systolic and diastolic BPV. These results supplement the differential ambulatory blood pressure–lowering effects of these therapies in the CREOLE trial.

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Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life

Lennon,

Lam,

Lipnicki

et al. 2023

JAMA Netw Open

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ImportanceThe utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested.ObjectivesTo assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age &gt;60 years) with dementia and the moderating factors of age, sex, and racial group.Data Source and Study SelectionLongitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included. Participants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries (US, Brazil, Australia, China, Korea, Singapore, Central African Republic, Republic of Congo, Nigeria, Germany, Spain, Italy, France, Sweden, and Greece).Data Extraction and SynthesisParticipants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. Baseline systolic BP (SBP) and diastolic BP (DBP) were treated as continuous variables. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analyses of Individual Participant Data reporting guidelines.Main Outcomes and MeasuresThe key outcome was all-cause dementia. Mixed-effects Cox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. The association between dementia and baseline BP was modeled using nonlinear natural splines. The main analysis was a partially adjusted Cox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. Sensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group.ResultsThe analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean (SD) age of 72.5 (7.5) years and a mean (SD) follow-up of 4.3 (4.3) years. In the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [HR], 1.42; 95% CI 1.15-1.76; P = .001) and 26% increased risk compared with individuals with treated hypertension (HR, 1.26; 95% CI, 1.03-1.53; P = .02). Individuals with treated hypertension had no significant increased dementia risk compared with healthy controls (HR, 1.13; 95% CI, 0.99-1.28; P = .07). The association of antihypertensive use or hypertension status with dementia did not vary with baseline BP. There was no significant association of baseline SBP or DBP with dementia risk in any of the analyses. There were no significant interactions with age, sex, or racial group for any of the analyses.Conclusions and RelevanceThis individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive use was associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. Individuals with treated hypertension had no increased risk of dementia compared with healthy controls.

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Blood pressure variability with different measurement methods

Cited by 35 publications

References 34 publications

Beat-to-beat blood pressure variability: an early predictor of disease and cardiovascular risk

Beat-to-beat blood pressure variability: an early predictor of disease and cardiovascular risk

Effect of 3, 2-Drug Combinations of Antihypertensive Therapies on Blood Pressure Variability in Black African Patients: Secondary Analyses of the CREOLE Trial

Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life

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