Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
Department of Psychology, University of Southern California, Los Angeles, CA, USA.
Sci Rep. 2024 Aug 30;14(1):20197. doi: 10.1038/s41598-024-71183-y.
Blood pressure variability (BPV) is emerging as an important risk factor across numerous disease states, including cerebrovascular and neurodegenerative disease in older adults. However, there is no current consensus regarding specific use cases for the numerous available BPV metrics. There is also little published data supporting the ability to reliably measure BPV across metrics in older adults. The present study derived BPV metrics from continuous beat-to-beat blood pressure monitoring data. Two sequential 7 min waveforms were analyzed. Absolute and relative reliability testing was performed. Differences between antihypertensive medication users and non-users on BPV metric reliability was also assessed. All sequence and dispersion based BPV metrics displayed good test-retest reliability. A measure of BP instability displayed only moderate reliability. Systolic and diastolic average real variability displayed the highest levels of reliability at ICC = 0.87 and 0.82 respectively. Additionally, systolic average real variability was the most reliable metric in both the antihypertensive use group, and the no antihypertensive use group. In conclusion, beat-to-beat dispersion and sequence-based metrics of BPV can be reliably obtained in older adults using noninvasive continuous blood pressure monitoring. Average real variability may be the most reliable and specific beat-to-beat blood pressure variability metric due to its decreased susceptibility to outliers and low frequency blood pressure oscillations.
血压变异性(BPV)在许多疾病状态下(包括老年人的脑血管和神经退行性疾病)正成为一个重要的风险因素。然而,对于众多可用的 BPV 指标,目前还没有关于具体用途的共识。也几乎没有发表的数据支持在老年人中可靠地测量跨指标的 BPV 能力。本研究从连续的逐拍血压监测数据中得出 BPV 指标。分析了两个连续的 7 分钟波型。进行了绝对和相对可靠性测试。还评估了抗高血压药物使用者和非使用者在 BPV 指标可靠性方面的差异。所有基于序列和离散的 BPV 指标均显示出良好的测试-再测试可靠性。血压不稳定的衡量标准仅显示出中等可靠性。收缩压和舒张压平均真实变异性的可靠性最高,ICC 分别为 0.87 和 0.82。此外,在使用抗高血压药物的组和未使用抗高血压药物的组中,收缩压平均真实变异性都是最可靠的指标。总之,使用非侵入性连续血压监测可以在老年人中可靠地获得逐拍的血压离散和序列 BPV 指标。由于其对外界干扰和低频血压波动的敏感性降低,平均真实变异性可能是最可靠和最具体的逐拍血压变异性指标。