Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
J Hypertens. 2021 Jul 1;39(7):1346-1351. doi: 10.1097/HJH.0000000000002810.
To assess the association between the variability of blood pressure (BP) readings within an initial clinic visit, the variability within subsequent visits and the variability between visits over 1 week in a general population.
This study included 1401 adult residents, who were not taking antihypertensive drugs, having BP measurements at three visits over 1 week. The difference between maximal and minimal BP readings (ΔBP), ΔBP/BPm (the mean BP value in a visit), the standard deviation (SD) and coefficient of variation (coefficient of variation = SD × 100/mean) of three BP values in each visit were used to estimate the within-visit BP variability (BPV). The SD and coefficient of variation of all nine BP readings over the three visits were calculated as SD9 or CV9 to reflect the overall BPV during the study visits. The SD and coefficient of variation on the mean BP values (BPm) of three visits were computed as SD-3 or CV-3, whereas the difference between maximal and minimal BP in three visits was computed as ΔBP-3 to estimate visit-to-visit BPV. The average BP or HR was the mean values of nine BP or HR readings over three visits.
The systolic and diastolic mean BP (SBP and DBP) decreased from the first to the third visit. The ΔBP, SD and coefficient of variation for both SBP and DBP at the first visit were positively and significantly correlated with the corresponding variables computed at the second and third visits, as well as with overall BPV (ΔBP9, SD9 and CV9). A positive correlation was also found between overall BPV and visit-to visit BPV (SD-3, CV-3 and ΔBP9). Multivariate analysis showed: no association between average SBP and systolic coefficient of variation or ΔBP/BPm but a negative association between average DBP and coefficient of variation or ΔBP/BPm for DBP at the first visit, DBP-3 and DBP9. Age was positively correlated with coefficient of variation or ΔBP/BPm for SBP at the first visit, SBP-3 and SBP9, and correlated with coefficient of variation and ΔBP/BPm for DBP only at the first visit.
In a general population, within-visit BPV at an initial visit is associated with within-visit BPV at subsequent visits and with visit-to-visit BPV over three visits within 1 week.
评估初始就诊时血压（BP）读数的变异性、随后就诊时的变异性以及 1 周内就诊间的变异性与一般人群的相关性。
本研究纳入了 1401 名未服用抗高血压药物的成年居民，他们在 1 周内进行了 3 次就诊时的 BP 测量。使用最大和最小 BP 读数之间的差异（ΔBP）、ΔBP/BPm（就诊时的平均 BP 值）、标准偏差（SD）和系数变化（系数变化=SD×100/平均值）来估计就诊内 BP 变异性（BPV）。计算所有 9 次就诊时的 SD 和所有 9 次 BP 读数的系数变化以反映研究就诊期间的整体 BPV。计算 3 次就诊时的 BPm 的 SD 和系数变化作为 SD-3 或 CV-3，而 3 次就诊时的最大和最小 BP 之间的差异则计算为ΔBP-3，以估计就诊间 BPV。平均 BP 或 HR 是 3 次就诊时 9 次 BP 或 HR 读数的平均值。
收缩压和舒张压的平均 BP（SBP 和 DBP）从第一次就诊到第三次就诊逐渐降低。第一次就诊时 SBP 和 DBP 的ΔBP、SD 和系数变化与第二次和第三次就诊时的相应变量以及整体 BPV（ΔBP9、SD9 和 CV9）呈正相关。整体 BPV 与就诊间 BPV（SD-3、CV-3 和ΔBP9）之间也存在正相关。多变量分析显示：平均 SBP 与收缩压系数变化或ΔBP/BPm 之间无关联，但第一次就诊时的平均 DBP 与系数变化或ΔBP/BPm 呈负相关，与 DBP-3 和 DBP9 呈负相关。年龄与第一次就诊时 SBP 的系数变化或ΔBP/BPm 呈正相关，与 SBP-3 和 SBP9 呈正相关，仅与第一次就诊时的 DBP 系数变化或ΔBP/BPm 呈正相关。
在一般人群中，初始就诊时的就诊内 BPV 与随后就诊时的就诊内 BPV 以及 1 周内 3 次就诊间的就诊间 BPV 相关。
