Day-by-Day Variability of Blood Pressure and Heart Rate at Home as a Novel Predictor of Prognosis

• DOI: 10.1161/hypertensionaha.107.104620
• Publication Date: 2008-11-04T02:36:01Z
• Authors: Masahiro Kikuya; Takayoshi Ohkubo; Hirohito Metoki; Kei Asayama; Azusa Hara; Taku Obara; Ryusuke Inoue; Haruhisa Hoshi; Junichiro Hashimoto; Kazuhito Totsune; Hiroshi Satoh; Yutaka Imai
• Keywords: Adult; Aged, 80 and over; Male; Heart Diseases; Incidence; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Middle Aged; Prognosis; Circadian Rhythm; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Japan; Heart Rate; Predictive Value of Tests; Risk Factors; Hypertension; Humans; Female; Prospective Studies; Aged; Follow-Up Studies

Day-by-day blood pressure and heart rate variability defined as within-subject SDs of home measurements can be calculated from long-term self-measurement. We investigated the prognostic value day-by-day in 2455 Ohasama, Japan, residents (baseline age: 35 to 96 years; 60.4% women). Home were measured once every morning for 26 days (median). A total 462 deaths occurred over a median 11.9 years, composing 168 cardiovascular (stroke: n=83; cardiac: n=85) 294 noncardiovascular deaths. Using Cox regression, we computed hazard ratios while adjusting baseline characteristics, including level, sex, age, obesity, current smoking drinking habits, history disease, diabetes mellitus, hyperlipidemia, treatment with antihypertensive drugs. An increase systolic +1 between-subject SD was associated increased (1.27; P =0.002) stroke mortality (1.41; =0.0009) but not cardiac (1.13; =0.26). Conversely, (1.24; (1.30; =0.003) (1.17; =0.12). Similar findings observed diastolic variability. Additional adjustment vice versa produced confirmatory results. Coefficient variation, divided by level or rate, displayed similar value. In conclusion, self-measurement at make up simple method providing useful clinical information assessing risk.