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Relationships between metrics of visit-to-visit variability of blood pressure

Journal of Human Hypertension volume 27, pages 589–593 (2013)Cite this article

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Abstract

This paper examines relationships between metrics of visit-to-visit variability (VVV) of blood pressure (BP) to determine which metrics should be calculated in studies of the association of VVV with health outcomes. We examined correlation and agreement between quintiles for standard deviation (s.d.), standard deviation independent of the mean (SDIM), coefficient of variation (CV), successive variation (SV), average real variability (ARV), range, maximum, peak size and trough size of systolic BP in the Trial of Preventing Hypertension placebo arm (n=288). The average age of participants was 48 years. Mean systolic BP was 133.5 mm Hg. VVV metrics were all significantly correlated (P<0.001). Correlations between s.d., SDIM, CV and range and between ARV and SV were⩾0.90. Kappa statistics between quintiles of SD, SDIM, CV and range and between ARV and SV were ⩾0.80. In studies of the relationship of VVV with health outcomes, we recommend reporting results for one of the metrics of overall variability (s.d., SDIM, CV), one of the metrics of variability between consecutive visits (SV, ARV), and one or more of the metrics of extreme values at a single visit (maximum, peak size, trough size).

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Acknowledgements

The TROPHY trial was sponsored by AstraZeneca. AstraZeneca had no role in the design, analysis or decision to publish the work described in this paper.

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Authors and Affiliations

  1. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA

    E B Levitan & P Muntner

  2. Department of Biostatistics, Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA

    N Kaciroti

  3. Division of Cardiovascular Disease, Department of Medicine, Vascular Biology and Hypertension Program, University of Alabama at Birmingham, Birmingham, AL, USA

    S Oparil

  4. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    S Julius

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  1. E B Levitan
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Correspondence to E B Levitan.

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Supplementary Information accompanies this paper on the Journal of Human Hypertension website

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Levitan, E., Kaciroti, N., Oparil, S. et al. Relationships between metrics of visit-to-visit variability of blood pressure. J Hum Hypertens 27, 589–593 (2013). https://doi.org/10.1038/jhh.2013.19

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