Factors affecting ambulatory blood pressure reproducibility. Results of the HARVEST Trial. Hypertension and Ambulatory Recording Venetia Study.

Abstract

To assess the reproducibility of ambulatory blood pressure, we recorded 24-hour blood pressure twice 3 months apart in 508 hypertensive subjects participating in the HARVEST trial using a noninvasive technique. Blood pressure was measured every 10 minutes during the daytime and 30 minutes during the nighttime. Reproducibility was better for ambulatory than for office blood pressure. It was greater for 24-hour than for daytime blood pressure and lowest for nighttime blood pressure. The reproducibility of blood pressure variability (standard deviation) was poorer than that of the average values. A small but significant decrease in average daytime blood pressure (-0.8/-1.0 mm Hg) and virtually no change in nighttime blood pressure (+0.5/+0.1 mm Hg) were observed at repeat recording. Reducing the sampling rate by 50% caused only a small impairment of the reproducibility indexes of both the average values and variability. Blood pressure reduction was greater during the first and last hours of the recordings, indicating an effect of the hospital environment on the between-monitoring difference. Changes in body weight (-0.7 kg, P = .006, at repeat recording) were related to those of 24-hour diastolic blood pressure (P < .05). In conclusion, patient reaction to medical environment and changes of body weight seem to account for most of the change in 24-hour blood pressure that occurs over a 3-month period.