Clinic, home and ambulatory pulse pressure: comparison and reproducibility
作者:
George Stergiou,
Stamatis Efstathiou,
Catherine Argyraki,
Alexandra Gantzarou,
Leonidas Roussias,
Theodore Mountokalakis,
期刊:
Journal of Hypertension
(OVID Available online 2002)
卷期:
Volume 20,
issue 10
页码: 1987-1993
ISSN:0263-6352
年代: 2002
出版商: OVID
关键词: pulse pressure;ambulatory blood pressure;home blood pressure;ambulatory pulse pressure;reproducibility
数据来源: OVID
摘要:
ObjectiveRecent evidence suggests that pulse pressure (PP) is an independent predictor of cardiovascular risk. The objective of this study was to compare mean values and reproducibility of PP obtained in the clinic (CPP), at home (HPP) and with ambulatory monitoring (APP) and to evaluate potential implications for trials aiming to assess drug effects on PP.MethodsA total of 393 hypertensive subjects [mean age 51.5±11.5 (SD) years, 59% men, 35% treated] measured CPP (two visits), HPP (6 days) and APP (24 h). The reproducibility of PP was assessed using the SD of differences (SDD) between measurements in 133 untreated subjects who had repeated CPP (five visits), HPP (6 days) and APP measurements (two occasions).ResultsThere was no difference between mean CPP (51.0±13.3 mmHg) and HPP (50.2±11.0) whereas APP (48.8±8.4) was lower than both CPP [mean difference 2.3±10.3 mmHg; 95% confidence interval (CI), 1.2, 3.3;P<0.01] and HPP (1.5±7.8; 95% CI, 0.7, 2.3;P<0.01). The SDD between repeated measurements was about 10 mmHg for CPP (one visit), 5.2 mmHg for HPP (2 days) and 4 mmHg for APP (24-h). For a parallel comparative trial aiming to detect a difference of 3 mmHg PP in the effect of two drugs, 415 subjects would be required when using CPP, compared to 127 using HPP and 63 using APP.ConclusionsThese data suggest that although differences among mean values of CPP, HPP and APP are small, differences in their reproducibility are important and should be taken into account in the design of trials assessing drug effects on PP.
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