Factors associated with intra-individual visit-to-vist variability in blood pressure in four countries: The INTERMAP Study
| Autor: | Naoyuki Takashima, Shigeyuki Saito, Queenie Chan, Jeremiah Stamler, Katsuyuki Miura, Akira Okayama, Nagako Okuda, Hirotsugu Ueshima, Hideaki Nakagawa, Sohel Reza Choudhury, Liancheng Zhao, Naoko Miyagawa, Kiyomi Sakata, Paul Elliott, Takayoshi Ohkubo |
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| Přispěvatelé: | National Institutes of Health, Medical Research Council (MRC) |
| Rok vydání: | 2018 |
| Předmět: |
Male
Population Blood Pressure 030204 cardiovascular system & hematology Article DISEASE 03 medical and health sciences 0302 clinical medicine AGE RISK-FACTOR Internal Medicine medicine Humans 030212 general & internal medicine Risk factor education CARDIOVASCULAR EVENTS Stroke POPULATION ALL-CAUSE MORTALITY education.field_of_study Science & Technology biology business.industry Confounding INTERMAP Study Group Blood Pressure Determination Angiotensin-converting enzyme 1103 Clinical Sciences ADULTS Middle Aged medicine.disease Intra individual Pulse rate Blood pressure Peripheral Vascular Disease Cardiovascular System & Hematology biology.protein Cardiovascular System & Cardiology Female business Life Sciences & Biomedicine STROKE Demography |
| Popis: | Several studies demonstrated that visit-to-visit variability of blood pressure (BP) predicted future events of total death, stroke and cardiovascular disease. Little is known about factors associated with visit-to-visit BP variability in different countries. We recruited participants aged 40–59 years from four countries (Japan, the People’s Republic of China [PRC], the United Kingdom [UK] and the United States [US]). At each study visit, BP was measured twice by trained observers using random zero sphygmomanometers after five minutes resting. We defined visit-to-visit BP variability as variation independent of mean (VIM) by using average systolic BP of 1st and 2nd measurement across four study visits. Data on 4680 men and women were analyzed. Mean ± standard deviation of VIM values among participants in Japan, the PRC, the UK and the US were 5.44 ± 2.88, 6.85 ± 3.49, 5.65 ± 2.81 and 5.84 ± 3.01, respectively; VIM value in the PRC participants was significantly higher. Sensitivity analyses among participants without antihypertensive treatment or past history of cardiovascular disease yielded similar results. Higher VIM value was associated with older age, female gender, lower pulse rate and urinary sodium excretion and use of antihypertensive agents such as angiotensin converting enzyme inhibitors, beta blockers and calcium channel blockers. The difference of visit-to-visit BP variability between PRC and other countries remained significant after adjustment for possible confounding factors. In this large international study across four countries, visit-to-visit BP variability in the PRC was higher than in the other three countries. Reproducibility and mechanisms of these findings remain to be elucidated. |
| Databáze: | OpenAIRE |
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