Significance of Cardiac Rehabilitation on Visit-to-Visit Variability of Blood Pressure in Patients With Cardiovascular Disease in a 12-Month Follow-Up

Toshihisa Ishida, Shin-ichiro Miura, Kanta Fujimi, Makito Futami, Yoko Ueda, Takashi Ueda, Tadaaki Arimura, Rie Koyoshi, Yuhei Shiga, Ken Kitajima, Keijiro Saku

Abstract


Background: Visit-to-visit variability (VVV) in blood pressure (BP) has been shown to be a strong predictor of cardiovascular disease (CVD). However, the long-term effect of comprehensive cardiac rehabilitation (CR) with exercise training on VVV in BP has not yet been established. Therefore, we evaluated the long-term effects of CR on VVV in BP in patients with CVD.

Methods: Twenty-two CVD patients in a 12-month CR program who had at least six clinic visits per month to measure BP were enrolled. We determined VVV in BP expressed as the standard deviation of average BP every month for 12 months.

Results: The mean age was 70 ± 8 years and the body mass index was 24.4 ± 4.9 kg/m2. In addition, the percentage (%) of males, % heart failure and % ischemic heart disease were 77%, 55% and 27%, respectively. Patients who had uncontrolled BP at baseline showed a significant reduction of both systolic BP (SBP) and diastolic BP (DBP). VVV in SBP in the first month was significantly less than that in the last month, although there was no difference in VVV in DBP. Patients were divided into larger (L-) and smaller (S-) VVV in SBP groups according to the average value of VVV in SBP as a cut-off. The L-VVV in SBP group, but not the S-VVV in SBP group, showed a significant reduction of VVV in SBP.

Conclusion: Comprehensive CR may improve VVV in SBP in CVD patients who have larger VVV in SBP.




J Clin Med Res. 2017;9(4):345-352
doi: https://doi.org/10.14740/jocmr2915w

 


Keywords


Exercise training; Cardiac rehabilitation; Blood pressure; Visit-to-visit variability

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