Hypertension Center STRIDE-7, National and Kapodistrian University of Athens, School of Medicine, Third Department of Medicine, Sotiria Hospital, Athens, Greece.
IRCCS, Istituto Auxologico Italiano, Department of Cardiology, San Luca Hospital.
J Hypertens. 2024 Aug 1;42(8):1350-1357. doi: 10.1097/HJH.0000000000003730. Epub 2024 Apr 4.
Blood pressure (BP) variability (BPV) can be assessed using office (OBP), home (HBP), or ambulatory BP (ABP) measurements. This analysis investigated the association and agreement between OBP, HBP, and ABP measurements for BPV assessment at baseline and 10 weeks after initiating antihypertensive drug therapy.
Untreated hypertensive patients with elevated BPV were randomized to receive an angiotensin-converting enzyme inhibitor (ramipril) or a calcium channel blocker (nifedipine GITS) in a 10-week, open-label, blinded-end point study. BPV was assessed using standard deviation (SD) and coefficient of variation (CV) (reading-to-reading analyses).
Data from 146 participants from three research centers (Athens/Greece; Milan/Italy; Shanghai/China) were analyzed [mean age 53 ± 10 (SD) years, male individuals 60%, baseline systolic OBP, HBP, and 24 h ABP 144 ± 9, 138 ± 10, and 143 ± 10 mmHg, respectively]. Post-treatment minus pre-treatment systolic CV difference was: OBP: 0.3%, P = 0.28; HBP: -0.2%, P = 0.20; 24 h ABP: 1.1%, P < 0.001. Home and ambulatory (not office) BPV indices presented weak-to-moderate correlation, both before and during treatment (range of coefficients 0.04-0.33). The correlation coefficient between systolic HBP and awake ABP CV was 0.21 and 0.28 before and during treatment, respectively ( P < 0.05/< 0.001, respectively). Home and ambulatory (not office) BPV indices presented slight-to-fair agreement (range 64-73%) in detecting participants with high systolic BPV (top quartile of respective distributions) both before and during treatment (kappa range 0.04-0.27).
These data showed a weak-to-moderate association between out-of-office (but not office) BPV indices both before and during BP-lowering treatment, with reasonable agreement in detecting individuals with high BPV. Out-of-office BP measurements provide more similar and consistent BPV information than office measurements.
血压变异性（BPV）可通过诊室（OBP）、家庭（HBP）或动态血压（ABP）测量进行评估。本分析研究了基线和开始降压药物治疗 10 周后，OBP、HBP 和 ABP 测量值评估 BPV 时的相关性和一致性。
患有高血压且血压变异性升高的未经治疗的高血压患者在一项为期 10 周、开放标签、盲终点研究中随机接受血管紧张素转换酶抑制剂（雷米普利）或钙通道阻滞剂（硝苯地平 GITS）治疗。BPV 使用标准差（SD）和变异系数（CV）（读数到读数分析）进行评估。
来自三个研究中心（希腊雅典、意大利米兰和中国上海）的 146 名参与者的数据进行了分析[平均年龄 53±10（SD）岁，男性占 60%，基线收缩压 OBP、HBP 和 24 小时 ABP 分别为 144±9、138±10 和 143±10mmHg]。治疗后减去治疗前的收缩压 CV 差值为：OBP：0.3%，P=0.28；HBP：-0.2%，P=0.20；24 小时 ABP：1.1%，P<0.001。家庭和动态（非诊室）BPV 指数在治疗前后均呈弱至中度相关性（系数范围为 0.04-0.33）。治疗前后，收缩压 HBP 和清醒时 ABP CV 的相关系数分别为 0.21 和 0.28（P<0.05/<0.001）。治疗前后，家庭和动态（非诊室）BPV 指数在检测高收缩压 BPV（各自分布的四分位上限）参与者方面具有轻微至中度的一致性（64-73%）（kappa 范围为 0.04-0.27）。
这些数据显示，在降压治疗前后，非诊室（而非诊室）BPV 指数之间存在弱至中度的相关性，在检测高 BPV 个体方面具有合理的一致性。与诊室测量相比，非诊室 BP 测量提供了更相似和一致的 BPV 信息。
