Analysis and Interpretation of 24-h Blood Pressure Profiles: Appropriate Mathematical Models May Yield Deeper Understanding

Parati, Gianfranco; Vrijens, Bernard; Vincze, G

doi:10.1038/ajh.2007.27

Cited by 20 publications

(22 citation statements)

References 12 publications

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“…However, short-term BPV can also be estimated (although less precisely) from intermittent, non-invasive 24-h ABPM recordings, allowing calculation of the standard deviation (SD) of average systolic, diastolic and mean arterial pressure values over the 24-h period, or during the daytime and nighttime subperiods [38]. However, the discontinuous sampling of BP variations over the 24 h and the inclusion in the calculation of 24-h BP SD of the degree of nocturnal BP fall (whose occurrence and magnitude carries a favorable prognostic value) have represented important limitations in the assessment of the prognostic relevance of 24-h BPV through this approach [39,40]. In order to overcome these difficulties, new parameters for quantifying short-term BPV over 24 h by excluding nighttime BP reduction have been recently proposed.…”

Section: Assessment Of Short-term Bpv With Abpmmentioning

confidence: 99%

Blood Pressure Variability, Cardiovascular Risk, and Risk for Renal Disease Progression

2012

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The adverse cardiovascular consequences of high blood pressure (BP) not only depend on absolute BP values, but also on BP variability (BPV). Evidence has been provided that independently of mean BP levels, BP variations in the short- and long-term are associated with the development, progression and severity of cardiac, vascular and renal organ damage, and with an increased risk of CV events and mortality. Alterations in BPV have also been shown to be predictive of the development and progression of renal damage, which is of relevance if considering that impaired renal function in a hypertensive patient constitutes a very potent predictor of future CV events and mortality even in treated subjects. This review will address whether antihypertensive treatment should target alterations in BPV, in addition to reducing absolute BP levels, in order to achieve the highest CV and renal protection in hypertensive and renal patients.

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Section: Assessment Of Short-term Bpv With Abpmmentioning

confidence: 99%

Blood Pressure Variability, Cardiovascular Risk, and Risk for Renal Disease Progression

2012

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“…Cosinor models and fourier analysis with different number of harmonics etc. [18,19,30] focused on describing the 24 h BP curve. With more than one cosine term, cosinor and fourier models share a similar description to circadian BP changes.…”

Section: Discussionmentioning

confidence: 99%

“…BP varies during the day following an inherent circadian rhythm [18,19]. Typically, a morning BP surge is observed and then the BP declines throughout the day into the evening.…”

mentioning

confidence: 99%

Misclassification and discordance of measured blood pressure from patient’s true blood pressure in current clinical practice: a clinical trial simulation case study

Jin

Bies

Gastonguay

et al. 2012

J Pharmacokinet Pharmacodyn

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Treatment decisions for hypertension using sphygmomanometer based measurements and the current clinical practice paradigm do not account for the timing of blood pressure (BP) measurement. This study aimed to evaluate the clinical implications of discordance between measured and true BP, to quantify BP misclassification rate at a typical clinical visit in current clinical practice, and to propose a BP calibration system to decrease the impact of timing of BP measurement. A clinical trial simulation case study was performed using an in silico Monte Carlo Simulation approach. The time-courses of BPs with and without an antihypertensive treatment effect were simulated from a baseline BP model combined with an antihypertensive PK/PD model. Virtual subject characteristics were sampled from the FDA internal database. The baseline BP model was qualified using observed 24 h ambulatory BP monitoring (ABPM) data from 225 subjects by a visual predictive check as well as a global sensitivity analysis. First of all, our results showed that the measured cuff BP in current typical clinical practice deviated from the true values. (1) Cuff BP deviated from the true values by more than 5 mmHg in 57 % (95 % CI: 54-61 %) of patients and more than 10 mmHg in 26 % (95 % CI: 22-32 %) of patients respectively. (2) These discordances were reduced to 28 % (deviation ≥ 5 mmHg, 95 % CI: 18-40 %) and 9 % (deviation ≥ 10 mmHg, 95 % CI: 4-18%) of patients assuming perfect sphygmomanometer measurement and thus represent the contribution of ignoring the daily circadian rhythm of BP. Secondly, our results showed 23-32 % of patients were misclassified to an incorrect BP category for a casual clinical visit based on JNC 7 guideline. In addition, the accuracy of the measured cuff BP varied by time of clinic visit. Specifically, 11:00 AM to 3:00 PM was identified to be the better time frame, while times before 9:00 AM were the worst time frame. Therefore, clinic visit time may need to be adjusted accordingly. Finally, we proposed an easy BP calibration method for clinic use to adjust for time of day differences due to circadian variability in case that the desirable clinic visit time cannot be tailored for practical reasons.

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“…Метаанализ нескольких проспективных исследований, опубли кованный в 2014 г., продемонстрировал ассоциа цию укорочения лейкоцитарных теломер с повы шенным риском ИБС [8,9]. Есть данные о том, что скорость укорочения теломер увеличивается еще до начала клинических проявлений заболевания, что может иметь диагностическое и прогностическое значение, поскольку измерение длины теломер в первые годы жизни способно указывать на гене тическую предрасположенность к сердечно-сосу дистым заболеваниям (ССЗ) и служить сигналом к своевременному началу профилактических и л е чебных мероприятий [10].…”

Section: актуальностьunclassified

Clinical Sings and Symptoms of Polyvascular Disease in Coronary Artery Disease Patients of Different Age Groups

Yahontov¹,

Ostanina²,

Pakharukova³

et al. 2017

Kompleks. probl. serdečno-sosud. zabol.

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Analysis and Interpretation of 24-h Blood Pressure Profiles: Appropriate Mathematical Models May Yield Deeper Understanding

Cited by 20 publications

References 12 publications

Blood Pressure Variability, Cardiovascular Risk, and Risk for Renal Disease Progression

Blood Pressure Variability, Cardiovascular Risk, and Risk for Renal Disease Progression

Misclassification and discordance of measured blood pressure from patient’s true blood pressure in current clinical practice: a clinical trial simulation case study

Clinical Sings and Symptoms of Polyvascular Disease in Coronary Artery Disease Patients of Different Age Groups

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