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Beat-to-beat, ambulatory hour-to-hour, and home day-to-day variabilities in blood pressure, pulse pressure, and heart rate in comparison with each other and with target-organ damage

Johansson, Jouni K.a; Puukka, Pauli J.a; Virtanen, Rainea,b; Jula, Antti M.a

doi: 10.1097/MBP.0000000000000101
Clinical Methods and Pathophysiology
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Objective The objective was to compare beat-to-beat, ambulatory hour-to-hour, and home day-to-day variability in blood pressure (BP), pulse pressure (PP), and heart rate (HR) with each other and with target-organ damage.

Methods We studied a population-based sample of Finnish adults including 150 healthy participants aged between 35 and 64 years. Variability in BP and HR was assessed using self-measured morning and evening recordings from seven consecutive days and 24-h ambulatory recordings. Frequency domain measures of beat-to-beat BP variability and baroreflex sensitivity were determined from 5-min time series. The study participants underwent clinical examination, a clinical interview, measurement of urine albumin levels, and echocardiographic examination.

Results Home BP/PP variability parameters and low frequency (LF) power of beat-to-beat BP/PP variability were mainly associated with left ventricular mass index (LVMI) in models adjusted for age, sex, and BP/PP level. The associations of LVMI with PP variability parameters were stronger than the corresponding associations with BP parameters. The associations of PP variability parameters with LVMI were stronger in old than in young individuals. Home BP/PP variability parameters were mainly associated with the LF power of beat-to-beat BP/PP variability in models adjusted for age, sex, and beat-to-beat BP/PP level and the associations were stronger in old than in young individuals. Home HR variability parameters and 24-h hour-to-hour HR variability were mainly associated with LF/high-frequency powers of beat-to-beat HR variability.

Conclusion Reading-to-reading BP/PP variability parameters and their corresponding beat-to-beat variability parameters are partially connected, possibly to common regulatory mechanisms. Their prognostic significance in relation to cardiovascular outcome needs further investigation.

aDepartment of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare

bTurku Heart Center, Turku University Hospital, Turku, Finland

All supplementary data is available directly from the corresponding author.

Correspondence to Jouni K. Johansson, MD, Department of Chronic Disease Prevention, Population Studies Unit, National Institute for Health and Welfare, Peltolantie 3, 20720 Turku, Finland Tel: +358 50 3586060; fax: +358 20 7547201; e-mail: jouni.johansson@utu.fi

Received August 18, 2014

Received in revised form October 6, 2014

Accepted November 19, 2014

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