Within-week variability of the home blood pressure in the NOSE study

Objective: Few studies have investigated weekly variations in long-term home blood pressure (BP) measurement. The aim of this study was to examine the within-week variability and the difference in the day of the week on long-term home BP with or without antihypertensive medication.

Design and method: This study was based on an ongoing community-based intervention study in Nose, Osaka, which was designed to assess the effect of home BP measurement on prolonging healthy life expectancy. The study included 618 participants aged 40-91 years. Participants measured their BP with an electronic oscillometric device (HEM-7281; Omron Healthcare CO., Ltd) and wrote the value on the recording book twice in morning and evening for about six months to a year. The participants were divided into 2 groups according to with or without antihypertensive medication. The within-week variability in home BP were calculated as maximum minus minimum BP (maximum-minimum difference [MMD]) by each week. The mixed model computed the last-squares means of morning and evening systolic BP (SBP) according to the category and tested the differences between all days of the week after Tukey-Kramer adjustment. Repeated-measures liner mixed model was used to analyze the factors associated with within-week variability.

Results: Morning SBP was highest on Thursday (without antihypertensive medication, 128.2 mmHg; with antihypertensive medication, 134.9 mmHg) and lowest on Saturday (127.6 mmHg, 134.1 mmHg), Evening SBP was highest on Sunday (120.7 mmHg, 127.3 mmHg) regardless of antihypertensive medication. Days of the week with the highest frequency of maximum SBP was Monday in the morning (19.4%, 22.2%) and Sunday in the evening (20.7%, 25.0%) regardless of antihypertensive medication. MMD in home SBP and DBP had significant positive relationships with age, measurement in winter, mean home BP, respectively by P<0.001, regardless of antihypertensive medication. And among participants without antihypertensive medication, MMD in home morning DBP had significantly negative relationships with BMI (coefficient = -0.01, P<0.05), and MMD in home evening SBP had significantly negative relationships with present of diabetes (coefficient = -3.42, P<0.001).

Conclusions: Evening SBP was highest on Sunday and days of the week with the highest frequency of maximum SBP was Monday in the morning and Sunday in the evening regardless of antihypertensive medication. These may be related with clinical evidence that cardiovascular events occur more frequently in the morning of Monday, but further analysis is needed to clarify these associations.

留言 (0)

沒有登入
gif