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12.01.2017 | Research Article | Ausgabe 1/2017

Clinical Autonomic Research 1/2017

Reliability of orthostatic beat-to-beat blood pressure tests: implications for population and clinical studies

Zeitschrift:
Clinical Autonomic Research > Ausgabe 1/2017
Autoren:
C. Finucane, G. M. Savva, R. A. Kenny
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s10286-016-0393-3) contains supplementary material, which is available to authorized users.

Abstract

Objective

To assess the test–retest reliability of orthostatic beat-to-beat blood pressure responses to active standing and related clinical definitions of orthostatic hypotension.

Methods

A random sample of community-dwelling older adults from the pan-European Survey of Health, Ageing and Retirement in Europe, Ireland underwent a health assessment that mimicked that of the Irish Longitudinal Study on Ageing. An active stand test was performed using continuous blood pressure measurements. Participants attended a repeat assessment 4–12 weeks after the initial measurement. A mixed-effects regression model estimated the reliability and minimum detectable change while controlling for fixed observer and time of day effects.

Results

A total of 125 individuals underwent repeat assessment (mean age 66.2 ± 7.5 years; 55.6% female). Mean time between visits was 84.3 ± 23.3 days. There was no significant mean difference in heart rate or blood pressure recovery variables between the first and repeat assessments. Minimum detectable change was noted for changes from resting values in systolic blood pressure (26.4 mmHg) and diastolic blood pressure (13.7 mmHg) at 110 s and for changes in heart rate (10.9 bpm) from resting values at 30 s after standing. Intra-class correlation values ranged from 0.47 for nadir values to 0.80 for heart rate and systolic blood pressure values measured 110 s after standing.

Conclusion

Continuous orthostatic beat-to-beat blood pressure and related clinical definitions show low to moderate reliability and substantial natural variation over a 4–12-week period. Understanding variation in measures is essential for study design or estimating the effects of orthostatic hypotension, while clinically it can be used when evaluating longer term treatment effects.

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Neu in den Fachgebieten Neurologie und Psychiatrie