(Hypertension. 2000;36:901.)
© 2000 American Heart Association, Inc.
Colin Johnston - A Celebration |
Prognostic Significance of Blood Pressure and Heart Rate Variabilities
The Ohasama Study
From the Departments of Clinical Pharmacology and Therapeutics (M.K., M.M., M.M., M.O., T.A., Y.I.), the Nephrology, Hypertension, and Endocrinology (S.I.), Public Health (A.H., T.O., I.T., S.H.), Environmental Health Science (H.S.), Tohoku University Graduate School of Medicine and Pharmaceutical Science, Sendai; and Ohasama Hospital (K.N.), Iwate, Japan.
Correspondence to Yutaka Imai, PhD, Department of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Medicine and Pharmaceutical Science, 1-1 Seiryomachi, Sendai, 980-8574, Japan.
Abstract—To investigate the
association between cardiovascular mortality and
short-term variabilities in blood pressure and heart rate, we
performed a long-term prospective study of ambulatory blood pressure
monitoring in Ohasama, Japan, starting in 1987. We obtained ambulatory
blood pressure and heart rate in 1542 subjects 
40 years of age. Blood
pressure and heart rate variabilities were estimated as a standard
deviation measured every 30 minutes by ambulatory monitoring. There
were 67 cardiovascular deaths during the follow-up
period (mean=8.5 years). The Cox proportional hazards model, adjusted
for possible confounding factors, demonstrated a significant increase
in cardiovascular mortality, with an increase in
daytime systolic ambulatory blood pressure variability. A
similar trend was observed in daytime diastolic and
nighttime ambulatory blood pressures. Cardiovascular
mortality rate increased linearly, with a decrease in daytime heart
rate variability. Subjects in whom the daytime systolic
ambulatory blood pressure variability was larger than third quintile
and the daytime heart rate variability was lower than the mean-SD were
at extremely high risk of cardiovascular mortality. The
blood pressure and heart rate variabilities obtained every 30 minutes
by ambulatory blood pressure monitoring were independent predictors for
cardiovascular mortality in the general
population.
Key Words: cohort study • ambulatory monitoring • cardiovascular diseases • mortality
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