Prognostic Value of the Variability in Home-Measured Blood Pressure and Heart Rate The Finn-Home Study
Prognostic Value of the Variability in Home-Measured Blood Pressure and Heart Rate The Finn-Home Study
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DOI：
10.1161/hypertensionaha.111.178657
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发表时间：
2012-02-01
期刊：
影响因子：
8.3
通讯作者：
Jula, Antti M.
中科院分区：
文献类型：
--
作者：
Johansson, Jouni K.;Niiranen, Teemu J.;Jula, Antti M.
该研究的目的是评估普通人群家庭测量的血压（BP）和心率（HR）变异性的预后价值。我们研究了芬兰成年人口的代表性样本，其中包括 1866 名年龄在 45-74 岁之间的研究对象。连续7天进行血压和心率自我测量。血压和心率的变异性定义为早晨减去晚上、每天以及第一次测量减去第二次测量的标准差。主要终点是心血管事件的发生率。次要终点是总死亡率。在 7.8 年的随访期间，179 名受试者经历了心血管事件，130 名受试者死亡。在针对年龄、性别、血压/心率和其他心血管危险因素进行调整的 Cox 比例风险模型中，早晚家庭血压变异性（收缩压/舒张压相对风险：血压变异性每增加 1 毫米汞柱，收缩压/舒张压相对风险：1.04/1.10 [95% CI：1.01-1.07/1.05-1.15]）和每日早晨家庭血压变异性（相对风险：血压变异性每增加 1 mm Hg，1.04/1.10 [95% CI：1.00-1.07/1.04-1.16] 可预测心血管事件。早晚家庭心率变异性（心率变异性每增加 1 bpm，相对危险度：1.07 [95% CI：1.02-1.12]）和每天早晨家庭心率变异性（心率变异性每增加 1 bpm，相对危险度：1.11 [95% CI：1.05-1.17]）也是心血管事件的独立预测因子。早晨在家血压和心率的较大变异性是心血管事件的独立预测因子。由于家庭血压和心率的变异性很容易与家庭血压和心率水平结合起来获得，因此它们应该作为心血管风险评估的附加信息。 （高血压。2012；59：212-218。）。在线数据补充
The objective of the study was to assess the prognostic value of variability in home-measured blood pressure (BP) and heart rate (HR) in a general population. We studied a representative sample of the Finnish adult population with 1866 study subjects aged 45-74 years. BP and HR self-measurements were performed on 7 consecutive days. The variabilities of BP and HR were defined as the SDs of morning minus evening, day-by-day, and first minus second measurements. The primary end point was incidence of a cardiovascular event. The secondary end point was total mortality. During a follow-up of 7.8 years, 179 subjects had experienced a cardiovascular event, and 130 subjects had died. In Cox proportional hazard models adjusted for age, sex, BP/HR, and other cardiovascular risk factors, morning-evening home BP variability (systolic/diastolic relative hazard: 1.04/1.10 [95% CI: 1.01-1.07/1.05-1.15] per 1-mm Hg increase in BP variability) and morning day-by-day home BP variability (relative hazard: 1.04/1.10 [95% CI: 1.00-1.07/1.04-1.16] per 1-mm Hg increase in BP variability) were predictive of cardiovascular events. Morning-evening home HR variability (relative hazard: 1.07 [95% CI: 1.02-1.12] per 1-bpm increase in HR variability) and morning day-by-day home HR variability (relative hazard: 1.11 [95% CI: 1.05-1.17] per 1-bpm increase in HR variability) were also independent predictors of cardiovascular events. Greater variabilities of morning home BP and HR are independent predictors of cardiovascular events. Because the variabilities of home BP and HR are easily acquired in conjunction with home BP and HR level, they should be used as the additive information in the assessment of cardiovascular risk. (Hypertension. 2012;59:212-218.) . Online Data Supplement