Finucane C, Savva G M, Kenny R A
Department of Medical Physics and Bioengineering, Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.
School of Health Sciences, Norwich Research Park, University of East Anglia, Norwich, NR4 7TJ, UK.
Clin Auton Res. 2017 Feb;27(1):31-39. doi: 10.1007/s10286-016-0393-3. Epub 2017 Jan 12.
To assess the test-retest reliability of orthostatic beat-to-beat blood pressure responses to active standing and related clinical definitions of orthostatic hypotension.
A random sample of community-dwelling older adults from the pan-European Survey of Health, Ageing and Retirement in Europe, Ireland underwent a health assessment that mimicked that of the Irish Longitudinal Study on Ageing. An active stand test was performed using continuous blood pressure measurements. Participants attended a repeat assessment 4-12 weeks after the initial measurement. A mixed-effects regression model estimated the reliability and minimum detectable change while controlling for fixed observer and time of day effects.
A total of 125 individuals underwent repeat assessment (mean age 66.2 ± 7.5 years; 55.6% female). Mean time between visits was 84.3 ± 23.3 days. There was no significant mean difference in heart rate or blood pressure recovery variables between the first and repeat assessments. Minimum detectable change was noted for changes from resting values in systolic blood pressure (26.4 mmHg) and diastolic blood pressure (13.7 mmHg) at 110 s and for changes in heart rate (10.9 bpm) from resting values at 30 s after standing. Intra-class correlation values ranged from 0.47 for nadir values to 0.80 for heart rate and systolic blood pressure values measured 110 s after standing.
Continuous orthostatic beat-to-beat blood pressure and related clinical definitions show low to moderate reliability and substantial natural variation over a 4-12-week period. Understanding variation in measures is essential for study design or estimating the effects of orthostatic hypotension, while clinically it can be used when evaluating longer term treatment effects.
评估主动站立时逐搏血压反应的重测信度以及体位性低血压的相关临床定义。
从泛欧洲健康、老龄化与退休调查中抽取的爱尔兰社区居住老年人随机样本，接受了类似于爱尔兰纵向老龄化研究的健康评估。使用连续血压测量进行主动站立测试。参与者在首次测量后4 - 12周接受重复评估。混合效应回归模型在控制固定观察者和每日时间效应的同时估计信度和最小可检测变化。
共有125人接受了重复评估（平均年龄66.2 ± 7.5岁；55.6%为女性）。两次就诊之间的平均时间为84.3 ± 23.3天。首次评估和重复评估之间，心率或血压恢复变量无显著平均差异。在站立110秒时，收缩压（26.4 mmHg）和舒张压（13.7 mmHg）相对于静息值的变化以及站立30秒后心率相对于静息值的变化（10.9 bpm）有最小可检测变化。组内相关值范围从最低点值的0.47到站立110秒时测量的心率和收缩压值的0.80。
连续的逐搏体位性血压及相关临床定义在4 - 12周期间显示出低至中度的信度和显著的自然变异。了解测量值的变异对于研究设计或评估体位性低血压的影响至关重要，而在临床评估长期治疗效果时也可加以利用。
