TITLE

Association of Heart Rate With Blood Pressure Variability: Implications for Blood Pressure Measurement

AUTHOR(S)
Cahan, Amos; Ben-Dov, Iddo Z.; Bursztyn, Michael
PUB. DATE
March 2012
SOURCE
American Journal of Hypertension;Mar2012, Vol. 25 Issue 3, p313
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
BackgroundAntihypertensive β-blocker use is associated with greater intervisit blood pressure variability (BPV) and with less favorable outcomes compared to other antihypertensive agents. A theoretical model demonstrated that accuracy and precision of BP measurement are affected by heart rate (HR) at a constant cuff deflation rate. We aimed to examine the empirical relationship between HR and BPV in a clinical setting.MethodsIntratracing variability in ambulatory BP monitoring (ABPM) were analyzed in search of a link between BPV and HR. BPV was expressed as standard deviation (s.d.), coefficient of variation (CV), and variability independent of the mean (VIM).ResultsIn a dataset of 4,693 subjects, HR was inversely associated with BPV and independently explained 1.3% of between-subject variation in s.d. of awake systolic BP (1.5% of CV and VIM). Linear regression suggested 0.5 mm Hg increase in s.d. of systolic BP per 10 beats per minute (bpm) decrease in HR. In a subset of 1,019 patients with available data on medications, HR was independently and inversely related with awake systolic BPV (P < 0.0001), more so in diuretic (P < 0.050) and renin-angiotensin system antagonists-treated (P < 0.050) patients. Associations of β-blockade with increased BPV were abolished by model-adjustment for HR. In another subset of patients who were monitored twice (n = 635), HR had a mild (0.6%) but significant (P < 0.05) inverse contribution to the change in awake systolic BPV between repeated monitoring.ConclusionsAmbulatory BPV is inversely related to HR and is not increased in referred patients treated with β-blockers after correction for HR.American Journal of Hypertension 2011; doi:10.1038/ajh.2011.230
ACCESSION #
71719094

 

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