Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia
Objective: To determine the reproducibility of visit-to-visit blood pressure variability (BPV) in clinical practice. We also determined the minimum number of blood pressure (BP) measurements needed to estimate long-term visit-to-visit BPV for predicting 10-year cardiovascular (CV) risk. Design: Retr...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2019
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| Online Access: | http://psasir.upm.edu.my/id/eprint/81496/1/Number%20of%20blood%20pressure%20measurements%20needed%20to%20estimate%20long-term%20visit-to-visit%20systolic%20blood%20pressure%20variability%20for%20predicting%20cardiovascular%20risk%20a%2010-year%20retrospective%20cohort%20study%20in%20a%20primary%20care%20clinic%20in%20Malaysia.pdf |
| _version_ | 1825951449306103808 |
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| author | Lim, Hooi Min Chia, Yook Chin Ching, Siew Mooi Chinna, Karuthan |
| author_facet | Lim, Hooi Min Chia, Yook Chin Ching, Siew Mooi Chinna, Karuthan |
| author_sort | Lim, Hooi Min |
| collection | UPM |
| description | Objective: To determine the reproducibility of visit-to-visit blood pressure variability (BPV) in clinical practice. We also determined the minimum number of blood pressure (BP) measurements needed to estimate long-term visit-to-visit BPV for predicting 10-year cardiovascular (CV) risk. Design: Retrospective study Setting: A primary care clinic in a university hospital in Malaysia. Participants: Random sampling of 1403 patients aged 30 years and above without any CV event at baseline. Outcomes measures: The effect of the number of BP measurement for calculation of long-term visit-to-visit BPV in predicting 10-year CV risk. CV events were defined as fatal and non-fatal coronary heart disease, fatal and non-fatal stroke, heart failure and peripheral vascular disease. Results: The mean 10-year SD of systolic blood pressure (SBP) for this cohort was 13.8±3.5 mm Hg. The intraclass correlation coefficient (ICC) for the SD of SBP based on the first eight and second eight measurements was 0.38 (p<0.001). In a primary care setting, visit-to-visit BPV (SD of SBP calculated from 20 BP measurements) was significantly associated with CV events (adjusted OR 1.07, 95% CI 1.02 to 1.13, p=0.009). Using SD of SBP from 20 measurement as reference, SD of SBP from 6 measurements (median time 1.75 years) has high reliability (ICC 0.74, p<0.001), with a mean difference of 0.6 mm Hg. Hence, a minimum of six BP measurements is needed for reliably estimating intraindividual BPV for CV outcome prediction. Conclusion: Long-term visit-to-visit BPV is reproducible in clinical practice. We suggest a minimum of six BP measurements for calculation of intraindividual visit-to-visit BPV. The number and duration of BP readings to derive BPV should be taken into consideration in predicting long-term CV risk. |
| first_indexed | 2024-03-06T10:30:11Z |
| format | Article |
| id | upm.eprints-81496 |
| institution | Universiti Putra Malaysia |
| language | English |
| last_indexed | 2024-03-06T10:30:11Z |
| publishDate | 2019 |
| publisher | BMJ Publishing Group |
| record_format | dspace |
| spelling | upm.eprints-814962021-01-30T00:04:57Z http://psasir.upm.edu.my/id/eprint/81496/ Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia Lim, Hooi Min Chia, Yook Chin Ching, Siew Mooi Chinna, Karuthan Objective: To determine the reproducibility of visit-to-visit blood pressure variability (BPV) in clinical practice. We also determined the minimum number of blood pressure (BP) measurements needed to estimate long-term visit-to-visit BPV for predicting 10-year cardiovascular (CV) risk. Design: Retrospective study Setting: A primary care clinic in a university hospital in Malaysia. Participants: Random sampling of 1403 patients aged 30 years and above without any CV event at baseline. Outcomes measures: The effect of the number of BP measurement for calculation of long-term visit-to-visit BPV in predicting 10-year CV risk. CV events were defined as fatal and non-fatal coronary heart disease, fatal and non-fatal stroke, heart failure and peripheral vascular disease. Results: The mean 10-year SD of systolic blood pressure (SBP) for this cohort was 13.8±3.5 mm Hg. The intraclass correlation coefficient (ICC) for the SD of SBP based on the first eight and second eight measurements was 0.38 (p<0.001). In a primary care setting, visit-to-visit BPV (SD of SBP calculated from 20 BP measurements) was significantly associated with CV events (adjusted OR 1.07, 95% CI 1.02 to 1.13, p=0.009). Using SD of SBP from 20 measurement as reference, SD of SBP from 6 measurements (median time 1.75 years) has high reliability (ICC 0.74, p<0.001), with a mean difference of 0.6 mm Hg. Hence, a minimum of six BP measurements is needed for reliably estimating intraindividual BPV for CV outcome prediction. Conclusion: Long-term visit-to-visit BPV is reproducible in clinical practice. We suggest a minimum of six BP measurements for calculation of intraindividual visit-to-visit BPV. The number and duration of BP readings to derive BPV should be taken into consideration in predicting long-term CV risk. BMJ Publishing Group 2019 Article PeerReviewed text en http://psasir.upm.edu.my/id/eprint/81496/1/Number%20of%20blood%20pressure%20measurements%20needed%20to%20estimate%20long-term%20visit-to-visit%20systolic%20blood%20pressure%20variability%20for%20predicting%20cardiovascular%20risk%20a%2010-year%20retrospective%20cohort%20study%20in%20a%20primary%20care%20clinic%20in%20Malaysia.pdf Lim, Hooi Min and Chia, Yook Chin and Ching, Siew Mooi and Chinna, Karuthan (2019) Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia. BMJ Open, 9. art. no. e025322. pp. 1-8. ISSN 2044-6055 https://www.researchgate.net/publication/332545536_Number_of_blood_pressure_measurements_needed_to_estimate_long-term_visit-to-visit_systolic_blood_pressure_variability_for_predicting_cardiovascular_risk_A_10-year_retrospective_cohort_study_in_a_prima 10.1136/bmjopen-2018-025322 |
| spellingShingle | Lim, Hooi Min Chia, Yook Chin Ching, Siew Mooi Chinna, Karuthan Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia |
| title | Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia |
| title_full | Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia |
| title_fullStr | Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia |
| title_full_unstemmed | Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia |
| title_short | Number of blood pressure measurements needed to estimate long-term visit-to-visit systolic blood pressure variability for predicting cardiovascular risk: a 10-year retrospective cohort study in a primary care clinic in Malaysia |
| title_sort | number of blood pressure measurements needed to estimate long term visit to visit systolic blood pressure variability for predicting cardiovascular risk a 10 year retrospective cohort study in a primary care clinic in malaysia |
| url | http://psasir.upm.edu.my/id/eprint/81496/1/Number%20of%20blood%20pressure%20measurements%20needed%20to%20estimate%20long-term%20visit-to-visit%20systolic%20blood%20pressure%20variability%20for%20predicting%20cardiovascular%20risk%20a%2010-year%20retrospective%20cohort%20study%20in%20a%20primary%20care%20clinic%20in%20Malaysia.pdf |
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