Factors affecting the variability of home-measured blood pressure and heart rate: the Finn-home study

Objective Information of the determinants affecting home blood pressure (BP) and heart rate (HR) variability is very limited. The objective of the study was to assess the determinants of home BP and HR variability in an unselected European population. Methods We studied a sample of 1908 patients aged 41-74 years. Study participants underwent a clinical examination and determination of serum lipids and glucose. Home BP and HR measurements were performed twice in the morning and in the evening during 7 consecutive days (28 measurements). BP and HR variability was defined as the SD of morning minus evening, day-by-day and first minus second measurements. Results Old age, cardiovascular disease, diabetes and high home BP were independent determinants of greater morning minus evening home BP variability. Old age, excessive use of alcohol and high home BP were independent determinants of greater day-by-day home BP variability, and old age, female sex, cardiovascular disease and high home BP were independent determinants of greater first minus second home BP variability. On the contrary, young age, moderate use of alcohol and high home HR were independent determinants of both greater morning minus evening and day-by-day home HR variability. In addition, young age, female sex and high home HR were independent determinants of first minus second home HR variability. Conclusion As home BP variability and HR variability have prognostic significance, it is important for the physicians to understand underlying causes of home BP and HR variation. Physicians should focus alcohol, diabetes and cardiovascular disease prevention counseling on their high-risk patients. J Hypertens 28:1836-1845 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.