TY - JOUR
T1 - How many measurements are needed to estimate blood pressure variability without loss of prognostic information?
AU - Mena, Luis J.
AU - Maestre, Gladys E.
AU - Hansen, Tine W.
AU - Thijs, Lutgarde
AU - Liu, Yanping
AU - Boggia, José
AU - Li, Yan
AU - Kikuya, Masahiro
AU - Björklund-Bodegard, Kristina
AU - Ohkubo, Takayoshi
AU - Jeppesen, Jørgen
AU - Torp-Pedersen, Christian
AU - Dolan, Eamon
AU - Kuznetsova, Tatiana
AU - Stolarz-Skrzypek, Katarzyna
AU - Tikhonoff, Valérie
AU - Malyutina, Sofia
AU - Casiglia, Edoardo
AU - Nikitin, Yuri
AU - Lind, Lars
AU - Sandoya, Edgardo
AU - Kawecka-Jaszcz, Kalina
AU - Filipovsky, Jan
AU - Lmai, Yutaka
AU - Wang, Jiguang
AU - O'Brien, Eoin
AU - Staessen, Jan A.
N1 - Funding Information:
The Secretaria de Educación Pública, México DF, México (PROMEP/103–5/11/4145 and PROMEP/103–5/11/6951) gave support for this investigation. The European Union (grants IC15-CT98-0329-EPOGH, LSHM-CT-2006–037093 InGenious HyperCare, HEALTH-F4-2007–201550 HyperGenes, HEALTH-F7-2011-278249 EU-MASCARA, and the European Research Council Advanced Research Grant 294713 EPLORE) and the Fonds voor Wetenschappelijk Onderzoek Vlaanderen, Ministry of the Flemish Community, Brussels, Belgium (G.0734.09) supported the Studies Coordinating Centre (Leuven, Belgium). The European Union (grants LSHM-CT-2006–037093 and HEALTH-F4-2007–201550) also supported the research groups in Shanghai, Kraków, Padova, and Novosibirsk. The Danish Heart Foundation (grant 01-2-9-9A-22914), and the Lundbeck Fonden (grant R32-A2740) supported the studies in Copenhagen. The Ohasama study received support via Grant-in-Aid for Scientific Research (22590767, 22790556, 23249036, 23390171, and 23790242) from the Ministry of Education, Culture, Sports, Science and Technology, Japan; Health Labour Sciences Research Grant (H23-Junkankitou [Seishuu]-Ippan-005) from the Ministry of Health, Labour and Welfare, Japan; Japan Arteriosclerosis Prevention Fund; and a grant from the Central Miso Research Institute, Tokyo, Japan. The National Natural Science Foundation of China (grants 30871360 and 30871081), Beijing, China, and the Shanghai Commissions of Science and Technology (grant 07JC14047 and the “Rising Star” program 06QA14043) and Education (grant 07ZZ32 and the “Dawn” project) supported the JingNing study in China. The Comisión Sectorial de Investigación Científica de la Universidad de la República (Grant I+D GEFA-HT-UY) and the Agencia Nacional de Innovación e Investigación supported research in Uruguay. Grant 1R01AG036469-01A1 from the National Institute on Aging and Fogarty International Center, grants G-97000726 and 98000726 from FONACIT, and grant LOCTI/008-2008 from FundaConciencia supported the Maracaibo Aging Study. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or any other funding agency.
PY - 2014/1
Y1 - 2014/1
N2 - Background Average real variability (ARV) is a recently proposed index for shortterm blood pressure (BP) variability. We aimed to determine the minimum number of BP readings required to compute ARV without loss of prognostic information. methods ARV was calculated from a discovery dataset that included 24-hour ambulatory BP measurements for 1,254 residents (mean age = 56.6 years; 43.5% women) of Copenhagen, Denmark. Concordance between ARV from full (=80 BP readings) and randomly reduced 24-hour BP recordings was examined, as was prognostic accuracy. A test dataset that included 5,353 subjects (mean age = 54.0 years; 45.6% women) with at least 48 BP measurements from 11 randomly recruited population cohorts was used to validate the results. results In the discovery dataset, a minimum of 48 BP readings allowed an accurate assessment of the association between cardiovascular risk and ARV. In the test dataset, over 10.2 years (median), 806 participants died (335 cardiovascular deaths, 206 cardiac deaths) and 696 experienced a major fatal or nonfatal cardiovascular event. Standardized multivariable-adjusted hazard ratios (HRs) were computed for associations between outcome and BP variability. Higher diastolic ARV in 24-hour ambulatory BP recordings predicted (P < 0.01) total (HR = 1.12), cardiovascular (HR = 1.19), and cardiac (HR = 1.19) mortality and fatal combined with nonfatal cerebrovascular events (HR = 1.16). Higher systolic ARV in 24-hour ambulatory BP recordings predicted (P < 0.01) total (HR = 1.12), cardiovascular (HR = 1.17), and cardiac (HR = 1.24) mortality. conclusions Forty-eight BP readings over 24 hours were observed to be adequate to compute ARV without meaningful loss of prognostic information.
AB - Background Average real variability (ARV) is a recently proposed index for shortterm blood pressure (BP) variability. We aimed to determine the minimum number of BP readings required to compute ARV without loss of prognostic information. methods ARV was calculated from a discovery dataset that included 24-hour ambulatory BP measurements for 1,254 residents (mean age = 56.6 years; 43.5% women) of Copenhagen, Denmark. Concordance between ARV from full (=80 BP readings) and randomly reduced 24-hour BP recordings was examined, as was prognostic accuracy. A test dataset that included 5,353 subjects (mean age = 54.0 years; 45.6% women) with at least 48 BP measurements from 11 randomly recruited population cohorts was used to validate the results. results In the discovery dataset, a minimum of 48 BP readings allowed an accurate assessment of the association between cardiovascular risk and ARV. In the test dataset, over 10.2 years (median), 806 participants died (335 cardiovascular deaths, 206 cardiac deaths) and 696 experienced a major fatal or nonfatal cardiovascular event. Standardized multivariable-adjusted hazard ratios (HRs) were computed for associations between outcome and BP variability. Higher diastolic ARV in 24-hour ambulatory BP recordings predicted (P < 0.01) total (HR = 1.12), cardiovascular (HR = 1.19), and cardiac (HR = 1.19) mortality and fatal combined with nonfatal cerebrovascular events (HR = 1.16). Higher systolic ARV in 24-hour ambulatory BP recordings predicted (P < 0.01) total (HR = 1.12), cardiovascular (HR = 1.17), and cardiac (HR = 1.24) mortality. conclusions Forty-eight BP readings over 24 hours were observed to be adequate to compute ARV without meaningful loss of prognostic information.
KW - Ambulatory blood pressure
KW - Blood pressure
KW - Blood pressure variability
KW - Epidemiology
KW - Hypertension
KW - Population science
KW - Risk factors
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U2 - 10.1093/ajh/hpt142
DO - 10.1093/ajh/hpt142
M3 - Article
C2 - 23955605
AN - SCOPUS:84890544881
VL - 27
SP - 46
EP - 55
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 1
ER -