Prognostic Significance of Blood Pressure and Heart Rate Variabilities: The Ohasama Study

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...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2000-11, Vol.36 (5), p.901-906
Main Authors: Kikuya, Masahiro, Hozawa, Atsushi, Ohokubo, Takayoshi, Tsuji, Ichiro, Michimata, Mari, Matsubara, Mitsunobu, Ota, Masahiro, Nagai, Kenichi, Araki, Tsutomu, Satoh, Hiroshi, Ito, Sadayoshi, Hisamichi, Shigeru, Imai, Yutaka
Format: Article
Language:English
Subjects:
Aged
Biological and medical sciences
Blood Pressure - physiology
Blood Pressure Monitoring, Ambulatory - statistics & numerical data
Cardiovascular Diseases - diagnosis
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Circadian Rhythm - physiology
Cohort Studies
Diabetes Mellitus - diagnosis
Diabetes Mellitus - epidemiology
Female
Fundamental and applied biological sciences. Psychology
Heart Rate - physiology
Hemodynamics. Rheology
Humans
Hyperlipidemias - diagnosis
Hyperlipidemias - epidemiology
Japan - epidemiology
Male
Middle Aged
Obesity - diagnosis
Obesity - epidemiology
Prevalence
Risk Factors
Vertebrates: cardiovascular system
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Summary: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.
ISSN:0194-911X
1524-4563
DOI:10.1161/01.HYP.36.5.901