J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 9, Number 4, April 2017, pages 345-352

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

Figure 1. Time courses of changes in blood pressure (BP) (a), visit-to-visit variability (VVV) in BP (b), heart rate (HR) (c) and VVV in HR (d) in all patients. *P < 0.05 vs. 0 months. #P < 0.05 vs. 1st month. SBP: systolic blood pressure; DBP: diastolic blood pressure; N.S.: not significant.

Figure 2. Time courses of changes in blood pressure (BP) in the controlled BP (a) and uncontrolled BP (b) groups. *P < 0.05, **P < 0.01 vs. 0 months. SBP: systolic blood pressure; DBP: diastolic blood pressure; N.S.: not significant.

Figure 3. Time courses of changes in visit-to-visit variability (VVV) in systolic blood pressure (SBP) in the larger (L-) and smaller (S-) VVV in SBP groups (a) and diastolic BP (DBP) in the L-VVV and S-VVV in DBP groups (b). *P < 0.05, **P < 0.01 vs. 1st month.

**Table 1.** Patient Characteristics and Biochemical Parameters in Blood at Baseline and After 12 Months in All Patients (n = 22)
	Baseline	12 months	P values (baseline vs. 12 months)
BMI: body mass index; HTN: hypertension; DL: dyslipidemia; DM: diabetes mellitus; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; LVEF: left ventricular ejection fraction; CVD: cardiovascular disease; HF: heart failure; IHD: ischemic heart disease; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker; BNP: brain natriuretic peptide; UN: urea nitrogen; Cr: creatinine; eGFR: estimated glomerular filtration rate; Na: sodium; K: potassium; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; HbA1c: hemoglobin A1c.
Age, years	70 ± 8	-	-
Male, n (%)	17 (77)	-	-
BMI, kg/m²	24.4 ± 4.9	24.6 ± 4.5	0.498
HTN, n (%)	17 (77)	-	-
DL, n (%)	16 (73)	-	-
DM, n (%)	9 (41)	-	-
SBP/DBP, mm Hg	139 ± 29/71 ± 13	135 ± 31/69 ± 13	0.385/0.211
HR, bpm	77 ± 15	73 ± 10	0.131
LVEF, %	58 ± 15	-	-
CVD
HF, n (%)	12 (55)	-	-
IHD, n (%)	6 (27)	-	-
Others, n (%)	4 (18)	-	-
Medication
ARB/ACE-I, n (%)	14 (64)	-	-
Diuretics, n (%)	12 (55)	-	-
CCB, n (%)	9 (41)	-	-
β-blocker, n (%)	12 (55)	-	-
Biochemical parameters in blood
BNP, pg/mL	185 ± 226	181 ± 243	0.779
UN, mg/dL	19 ± 8	20 ± 9	0.938
Cr, mg/dL	1.3 ± 1.3	1.4 ± 1.3	0.030
eGFR, mL/min/1.73 m²	57 ± 16	52 ± 15	0.106
Na, mmol/L	139 ± 3	140 ± 3	0.650
K, mmol/L	4.4 ± 0.5	4.4 ± 0.5	0.480
LDL-C, mg/dL	89 ± 23	77 ± 18	0.307
HDL-C, mg/dL	45 ± 13	50 ± 13	0.028
TG, mg/dL	139 ± 58	129 ± 74	0.754
HbA1c (%)	6.5 ± 0.6	6.7 ± 1	0.208

Table 1. Patient Characteristics and Biochemical Parameters in Blood at Baseline and After 12 Months in All Patients (n = 22)

Baseline

12 months

P values (baseline vs. 12 months)

BMI: body mass index; HTN: hypertension; DL: dyslipidemia; DM: diabetes mellitus; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; LVEF: left ventricular ejection fraction; CVD: cardiovascular disease; HF: heart failure; IHD: ischemic heart disease; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker; BNP: brain natriuretic peptide; UN: urea nitrogen; Cr: creatinine; eGFR: estimated glomerular filtration rate; Na: sodium; K: potassium; LDL-C: low-density lipoprotein cholesterol; HDL-C: high-density lipoprotein cholesterol; TG: triglyceride; HbA1c: hemoglobin A1c.

Age, years

70 ± 8

Male, n (%)

17 (77)

BMI, kg/m²

24.4 ± 4.9

24.6 ± 4.5

0.498

HTN, n (%)

17 (77)

DL, n (%)

16 (73)

DM, n (%)

9 (41)

SBP/DBP, mm Hg

139 ± 29/71 ± 13

135 ± 31/69 ± 13

0.385/0.211

HR, bpm

77 ± 15

73 ± 10

0.131

LVEF, %

58 ± 15

CVD

HF, n (%)

12 (55)

IHD, n (%)

6 (27)

Others, n (%)

4 (18)

Medication

ARB/ACE-I, n (%)

14 (64)

Diuretics, n (%)

12 (55)

CCB, n (%)

9 (41)

β-blocker, n (%)

12 (55)

Biochemical parameters in blood

BNP, pg/mL

185 ± 226

181 ± 243

0.779

UN, mg/dL

19 ± 8

20 ± 9

0.938

Cr, mg/dL

1.3 ± 1.3

1.4 ± 1.3

0.030

eGFR, mL/min/1.73 m²

57 ± 16

52 ± 15

0.106

Na, mmol/L

139 ± 3

140 ± 3

0.650

K, mmol/L

4.4 ± 0.5

0.480

LDL-C, mg/dL

89 ± 23

77 ± 18

0.307

HDL-C, mg/dL

45 ± 13

50 ± 13

0.028

TG, mg/dL

139 ± 58

129 ± 74

0.754

HbA1c (%)

6.5 ± 0.6

6.7 ± 1

0.208

**Table 2.** Patient Characteristics at Baseline and After 12 Months in the Controlled and Uncontrolled BP Groups
	Controlled BP group (n = 10)	Uncontrolled BP group (n = 12)
BMI: body mass index; HTN: hypertension; DL: dyslipidemia; DM: diabetes mellitus; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; LVEF: left ventricular ejection fraction; CVD: cardiovascular disease; HF: heart failure; IHD: ischemic heart disease; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker. P < 0.05 vs. at baseline in the uncontrolled group. *P < 0.01 vs. at baseline in the controlled group.
Age, years	70 ± 8	-	71 ± 9	-
Male, n (%)	7 (70)	-	10 (83)	-
BMI, kg	24.2 ± 3.4	24.6 ± 3.3	24.5 ± 6.1	24.7 ± 5.5
HTN, n (%)	8 (80)	-	9 (75)	-
DL, n (%)	8 (80)	-	8 (67)	-
DM, n (%)	3 (30)	-	6 (50)	-
SBP/DBP, mm Hg	115 ± 15/63 ± 11	118 ± 22/65 ± 11	158 ± 21/79 ± 9	149 ± 30/73 ± 13*
HR, bpm	80 ± 17	71 ± 11	74 ± 13	74 ± 10
LVEF, %	57 ± 17		60 ± 13
CVD
HF, n (%)	6 (60)	-	6 (50)	-
IHD, n (%)	3 (30)	-	3 (25)	-
Others, n (%)	1 (10)	-	3 (25)	-
Medication
ARB/ACE-I, n (%)	8 (80)	-	6 (50)	-
Diuretics, n (%)	3 (30)	-	6 (50)	-
CCB, n (%)	7 (70)	-	5 (42)	-
β-blocker, n (%)	6(60)	-	6 (50)	-

Table 2. Patient Characteristics at Baseline and After 12 Months in the Controlled and Uncontrolled BP Groups

Controlled BP group (n = 10)

Uncontrolled BP group (n = 12)

Baseline

12 months

Baseline

12 months

BMI: body mass index; HTN: hypertension; DL: dyslipidemia; DM: diabetes mellitus; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; LVEF: left ventricular ejection fraction; CVD: cardiovascular disease; HF: heart failure; IHD: ischemic heart disease; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker. *P < 0.05 vs. at baseline in the uncontrolled group. **P < 0.01 vs. at baseline in the controlled group.

Age, years

70 ± 8

71 ± 9

Male, n (%)

7 (70)

10 (83)

BMI, kg

24.2 ± 3.4

24.6 ± 3.3

24.5 ± 6.1

24.7 ± 5.5

HTN, n (%)

8 (80)

9 (75)

DL, n (%)

8 (80)

8 (67)

DM, n (%)

3 (30)

6 (50)

SBP/DBP, mm Hg

115 ± 15/63 ± 11

118 ± 22/65 ± 11

158 ± 21**/79 ± 9**

149 ± 30/73 ± 13*

HR, bpm

80 ± 17

71 ± 11

74 ± 13

74 ± 10

LVEF, %

57 ± 17

60 ± 13

CVD

HF, n (%)

6 (60)

6 (50)

IHD, n (%)

3 (30)

3 (25)

Others, n (%)

1 (10)

3 (25)

Medication

ARB/ACE-I, n (%)

8 (80)

6 (50)

Diuretics, n (%)

3 (30)

6 (50)

CCB, n (%)

7 (70)

5 (42)

β-blocker, n (%)

6(60)

6 (50)

**Table 3.** Patient Characteristics and Biochemical Parameters in Blood at Baseline and After 12 Months in the Smaller (S-) and Larger (L-) VVV in SBP Groups
	S-VVV in SBP group (n = 16)	L-VVV in SBP group (n = 6)
VVV: visit-to-visit variability; BMI: body mass index; HTN: hypertension; DL: dyslipidemia; DM: diabetes mellitus; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; LVEF: left ventricular ejection fraction; CVD: cardiovascular disease; HF: heart failure; IHD: ischemic heart disease; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker.
Age, years	72 ± 7	-	66 ± 10	-
Male, n (%)	11 (69)	-	6 (100)	-
BMI, kg	24.9 ± 5.2	25.0 ± 4.5	23.0 ± 4.1	23.6 ± 4.9
HTN, n (%)	13 (81)	-	4 (67)	-
DL, n (%)	12 (75)	-	4 (67)	-
DM, n (%)	6 (38)	-	3 (50)	-
SBP/DBP, mm Hg	133 ± 28/69 ± 12	128 ± 27/67 ± 11	153 ± 25/78 ± 13	153 ± 35/75 ± 15
HR, bpm	77 ± 16	72 ± 9	78 ± 10	75 ± 13
LVEF, %	57 ± 16	-	63 ± 9	-
CVD
HF, n (%)	9 (56)	-	3 (50)	-
IHD, n (%)	4 (25)	-	2 (33)	-
Others, n (%)	3 (19)	-	1 (17)	-
Medication
ARB/ACE-I, n (%)	11 (69)	-	3 (50)	-
Diuretics, n (%)	9 (56)	-	3 (50)	-
CCB, n (%)	6 (38)	-	3 (50)	-
β-blocker, n (%)	10 (63)	-	2 (33)	-

Table 3. Patient Characteristics and Biochemical Parameters in Blood at Baseline and After 12 Months in the Smaller (S-) and Larger (L-) VVV in SBP Groups

S-VVV in SBP group (n = 16)

L-VVV in SBP group (n = 6)

Baseline

12 months

Baseline

12 months

VVV: visit-to-visit variability; BMI: body mass index; HTN: hypertension; DL: dyslipidemia; DM: diabetes mellitus; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; LVEF: left ventricular ejection fraction; CVD: cardiovascular disease; HF: heart failure; IHD: ischemic heart disease; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker.

Age, years

72 ± 7

66 ± 10

Male, n (%)

11 (69)

6 (100)

BMI, kg

24.9 ± 5.2

25.0 ± 4.5

23.0 ± 4.1

23.6 ± 4.9

HTN, n (%)

13 (81)

4 (67)

DL, n (%)

12 (75)

4 (67)

DM, n (%)

6 (38)

3 (50)

SBP/DBP, mm Hg

133 ± 28/69 ± 12

128 ± 27/67 ± 11

153 ± 25/78 ± 13

153 ± 35/75 ± 15

HR, bpm

77 ± 16

72 ± 9

78 ± 10

75 ± 13

LVEF, %

57 ± 16

63 ± 9

CVD

HF, n (%)

9 (56)

3 (50)

IHD, n (%)

4 (25)

2 (33)

Others, n (%)

3 (19)

1 (17)

Medication

ARB/ACE-I, n (%)

11 (69)

3 (50)

Diuretics, n (%)

9 (56)

3 (50)

CCB, n (%)

6 (38)

3 (50)

β-blocker, n (%)

10 (63)

2 (33)

**Table 4.** Patient Characteristics at Baseline and After 12 Months in the Smaller (S-) and Larger (L-) VVV in DBP Groups
	S-VVV in DBP group (n = 14)	L-VVV in DBP group (n = 8)
VVV: visit-to-visit variability; BMI: body mass index; HTN: hypertension; DL: dyslipidemia; DM: diabetes mellitus; SBP: systolic blood pressure; DBP: diastolic blood pressure; HR: heart rate; LVEF: left ventricular ejection fraction; CVD: cardiovascular disease; HF: heart failure; IHD: ischemic heart disease; ARB: angiotensin II receptor blocker; ACE-I: angiotensin converting enzyme inhibitor; CCB: calcium channel blocker.
Age, years	72 ± 7	-	67 ± 9	-
Male, n (%)	9 (64)		8 (100)	-
BMI, kg	23.3 ± 3.3	23.4 ± 3.2	26.3 ± 6.8	26.8 ± 5.8
HTN, n (%)	10 (71)	-	7 (88)	-
DL, n (%)	10 (71)	-	6 (75)	-
DM, n (%)	6 (43)	-	3 (38)	-
SBP/DBP, mm Hg	140 ± 26/72 ± 9	131 ± 32/67 ± 11	136 ± 34/71 ± 18	141 ± 29/73 ± 15
HR, bpm	79 ± 16	74 ± 11	73 ± 11	71 ± 10
LVEF, %	58 ± 16	-	60 ± 13	-
CVD
HF, n (%)	4 (29)	-	2 (25)	-
IHD, n (%)	6 (43)	-	6 (75)	-
Others, n (%)	4 (29)	-	0 (0)	-
Medication
ARB/ACE-I, n (%)	9 (64)	-	5 (63)	-
Diuretics, n (%)	6 (43)	-	6 (75)	-
CCB, n (%)	5 (36)	-	4 (50)	-
β-blocker, n (%)	8 (57)	-	4 (50)	-

Table 4. Patient Characteristics at Baseline and After 12 Months in the Smaller (S-) and Larger (L-) VVV in DBP Groups

S-VVV in DBP group (n = 14)

L-VVV in DBP group (n = 8)

Baseline

12 months

Baseline

12 months

Age, years

72 ± 7

67 ± 9

Male, n (%)

9 (64)

8 (100)

BMI, kg

23.3 ± 3.3

23.4 ± 3.2

26.3 ± 6.8

26.8 ± 5.8

HTN, n (%)

10 (71)

7 (88)

DL, n (%)

10 (71)

6 (75)

DM, n (%)

6 (43)

3 (38)

SBP/DBP, mm Hg

140 ± 26/72 ± 9

131 ± 32/67 ± 11

136 ± 34/71 ± 18

141 ± 29/73 ± 15

HR, bpm

79 ± 16

74 ± 11

73 ± 11

71 ± 10

LVEF, %

58 ± 16

60 ± 13

CVD

HF, n (%)

4 (29)

2 (25)

IHD, n (%)

6 (43)

6 (75)

Others, n (%)

4 (29)

0 (0)

Medication

ARB/ACE-I, n (%)

9 (64)

5 (63)

Diuretics, n (%)

6 (43)

6 (75)

CCB, n (%)

5 (36)

4 (50)

β-blocker, n (%)

8 (57)

4 (50)