Linear relationship between systolic and diastolic blood pressure monitored over 24 h: assessment and correlates

Journal of Hypertension
Benjamin GavishMichael Bursztyn

Abstract

Systolic blood pressure (SBP) and diastolic blood pressure (DBP) frequently display a linear relationship characterized by the systolic-versus-diastolic slope ('Slope') or the 'ambulatory arterial stiffness index' [AASI = 1 - (diastolic-versus-systolic Slope)] and the correlation coefficient r. We evaluated the effect of using symmetric regression on the AASI and its dependence on clinical characteristics using 24-h ambulatory monitoring. Ambulatory monitoring data of 140 patients (age 56 +/- 17 years, 45% men) were retrieved from a service database. Slope and the AASI were evaluated using symmetric regression procedures, and the AASI also by standard regression. Correlation between SBP and DBP was r = 0.74 +/- 0.14 (r > 0.5 in 95% of patients). Low r-values (when SBP correlates poorly with DBP) were tightly linked with nondipping (P < 0.00001). Use of symmetric rather than standard regression eliminated the bias in slope-related parameters and unmasked their dependence on clinical characteristics. Both symmetric Slope and the AASI were independent of mean arterial pressure and r, increased with pulse pressure (P < 0.01 and P < 0.0001, respectively), with the greater effect of wider pulse pressure in older age (P < 0.005 for bo...Continue Reading

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