Ambulatory Blood Pressure Variability Increases Over a 10-Year Follow-Up in Community-Dwelling Older People
| Autor: | Claire McDonald, Mark S. Pearce, Julia L. Newton, Simon Kerr, Joanna Wincenciak |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Gerontology Aging medicine.medical_specialty Longitudinal study Mean arterial pressure Time Factors Ambulatory blood pressure Diastole Blood Pressure Physical examination 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Risk Factors Internal medicine Internal Medicine medicine Humans Longitudinal Studies 030212 general & internal medicine Aged Models Statistical medicine.diagnostic_test business.industry 10 year follow up Age Factors Blood Pressure Monitoring Ambulatory Circadian Rhythm Blood pressure England Original Article Female Independent Living Older people business Follow-Up Studies |
| Zdroj: | American Journal of Hypertension. 29:560-567 |
| ISSN: | 1941-7225 0895-7061 |
| DOI: | 10.1093/ajh/hpv150 |
| Popis: | BACKGROUND: Greater ambulatory blood pressure variability (ABPV) is associated with end-organ damage and increased mortality. Age-related changes in the cardiovascular and autonomic nervous systems make age-associated increases in ABPV likely. Cross-sectional studies support this hypothesis, showing greater ABPV among older compared to younger adults. The only longitudinal study to examine changes in ABPV, however, found ABPV decreased over 5 years follow-up. This unexpected observation probably reflected the highly selected nature of the study participants. METHODS In this longitudinal study, we assessed changes in ABPV over 10 years in a community-cohort of older people. In addition, we examined the extent to which ABPV was predicted by demographics, cardiovascular risk factors, and medication. Clinical examination and 24-hour ambulatory blood pressure monitoring were carried out at baseline and at 10 years follow-up in 83 people, median age 70 years. ABPV was calculated using SD and coefficient of variation (Cv). Three time periods were examined: daytime, nighttime, and 24 hours. RESULTS: Daytime and 24-hour, systolic and diastolic, SD, and Cv were significantly greater at follow-up than at baseline (P < 0.001 in all cases). Mean BP did not change. CONCLUSIONS: Multilevel modeling showed follow-up interval had a significant, positive effect on SD and Cv (P < 0.004), independent of age, sex, and medication. ABPV increased over a 10-year follow-up despite stable mean BP. ABPV may therefore be an additional target for treatment in older people. Future studies should examine what degree of ABPV is harmful and if control of ABPV reduces adverse outcome. |
| Databáze: | OpenAIRE |
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