Population Studies Unit, Department of Chronic Disease Prevention, National Institute for Health and Welfare, Turku, Finland.
J Hypertens. 2010 Sep;28(9):1836-45. doi: 10.1097/HJH.0b013e32833b6c8a.
Information of the determinants affecting home blood pressure (BP) and heart rate (HR) variability is very limited. The objective of the study was to assess the determinants of home BP and HR variability in an unselected European population.
We studied a sample of 1908 patients aged 41-74 years. Study participants underwent a clinical examination and determination of serum lipids and glucose. Home BP and HR measurements were performed twice in the morning and in the evening during 7 consecutive days (28 measurements). BP and HR variability was defined as the SD of morning minus evening, day-by-day and first minus second measurements.
Old age, cardiovascular disease, diabetes and high home BP were independent determinants of greater morning minus evening home BP variability. Old age, excessive use of alcohol and high home BP were independent determinants of greater day-by-day home BP variability, and old age, female sex, cardiovascular disease and high home BP were independent determinants of greater first minus second home BP variability. On the contrary, young age, moderate use of alcohol and high home HR were independent determinants of both greater morning minus evening and day-by-day home HR variability. In addition, young age, female sex and high home HR were independent determinants of first minus second home HR variability.
As home BP variability and HR variability have prognostic significance, it is important for the physicians to understand underlying causes of home BP and HR variation. Physicians should focus alcohol, diabetes and cardiovascular disease prevention counseling on their high-risk patients.
影响家庭血压（BP）和心率（HR）变异性的相关因素信息非常有限。本研究旨在评估未经选择的欧洲人群中家庭 BP 和 HR 变异性的决定因素。
我们研究了 1908 名年龄在 41-74 岁的患者样本。研究参与者接受了临床检查以及血清脂质和葡萄糖的测定。家庭 BP 和 HR 测量在连续 7 天的早晨和晚上进行两次（共 28 次测量）。BP 和 HR 变异性被定义为早晨与晚上、每日和第一次与第二次测量之间的 SD。
年龄较大、心血管疾病、糖尿病和较高的家庭 BP 是早晨与晚上家庭 BP 变异性更大的独立决定因素。年龄较大、过量饮酒和较高的家庭 BP 是每日家庭 BP 变异性更大的独立决定因素，而年龄较大、女性、心血管疾病和较高的家庭 BP 是早晨与晚上和每日家庭 BP 变异性更大的独立决定因素。相反，年龄较小、适量饮酒和较高的家庭 HR 是早晨与晚上和每日家庭 HR 变异性更大的独立决定因素。此外，年龄较小、女性和较高的家庭 HR 是第一次与第二次家庭 HR 变异性更大的独立决定因素。
由于家庭 BP 变异性和 HR 变异性具有预后意义，因此医生了解家庭 BP 和 HR 变化的潜在原因非常重要。医生应将酒精、糖尿病和心血管疾病预防咨询的重点放在高风险患者身上。
