Home blood pressure has a stronger association with arterial stiffness than clinic blood pressure: the Finn-Home Study

Objectives Most of the earlier studies assessing the determinants of pulse wave velocity (PWV) have been conducted with conventional clinic blood pressure (BP) measurements. The aim of this study was to assess whether PWV is more strongly associated with home-measured BP than clinic BP. Other risk factors associated with PWV were also investigated. Methods The study population was an unselected sample of 237 adults aged 45-74 years. The study participants underwent the measurement of PWV, clinic BP (mean of two measurements using a mercury sphygmomanometer) and home BP (mean of 14 duplicate measurements during 1 week using a validated, automatic device). Fasting blood samples for serum lipids and glucose were drawn. Results Pearson's correlation coefficients for PWV and home/clinic BP differed significantly in favour of home measurement for systolic BP (0.65 vs. 0.50, P<0.001), diastolic BP (0.51 vs. 0.37, P<0.001) and pulse pressure (0.62 vs. 0.40, P<0.001). In a linear regression model (R-2=0.60, P<0.001), home systolic BP (P<0.001), age (P<0.001) and diabetes (P<0.001) were independently associated with increased PWV. The association between home BP and PWV increased only slightly with the number of home measurements. Conclusion Home BP is one of the most important factors affecting arterial stiffness, a strong predictor of cardiovascular risk. Home-measured BP is more strongly associated with PWV than is clinic BP, even for a low number of measurements. These data support the application of home BP measurement in clinical practice, as it seems to produce values that represent true BP better than clinic BP. Blood Press Monit 14:196-201 (C) 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins.