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Impact of within-visit systolic blood pressure change patterns on blood pressure classification: The cardiovascular risk in Young Finns Study


Meng, Y and Magnussen, CG and Wu, F and Juonala, M and Buscot, M-J and Pahkala, K and Hutri-Kahonen, N and Kahonen, M and Laitinen, T and Viikari, JSA and Raitakari, OT and Sharman, JE, Impact of within-visit systolic blood pressure change patterns on blood pressure classification: The cardiovascular risk in Young Finns Study, European Journal of Preventive Cardiology, 15, (29) pp. 2090-2098. ISSN 2047-4873 (2022) [Refereed Article]

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2022. The Authors. Published by Oxford University Press on behalf of the European Society of Cardiology. This article is licensed under a Creative Commons Attribution 4.0 International (CC BY 4.0) License (, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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DOI: doi:10.1093/eurjpc/zwac108


Background and aims: Most international guidelines recommend that repeat blood pressure (BP) readings are required for BP classification. Two international guidelines diverge from this by recommending that no further BP measurements are required if the first clinic BP is below a hypertension threshold. The extent to which within-visit BP variability patterns change over time, and whether this could impact BP classification is unknown. We sought to examine this.

Methods: Data were from the Cardiovascular Risk in Young Finns study, a prospective cohort study. Up to 2799 participants were followed from childhood (9-15 years) to adulthood (18-49 years) over up to 6 visits. Patterns of within-visit systolic BP (SBP) variability were defined as no-change, a decrease, increase between consecutive readings (with 5 mmHg change thresholds). Classification of SBP (normal, high-normal, hypertension) using the first reading was compared with repeat readings.

Results: On average, SBP decreased with subsequent measures, but with major individual variability (no-change: 56.9%-62.7%; decrease: 24.1%-31.6%; increase: 11.5%-16.8%). Patterns of SBP variability were broadly similar from childhood to adulthood, with the highest prevalence of an increase among participants categorised with normal SBP (12.6%-20.3%). The highest prevalence of SBP reclassification occurred among participants with hypertension (28.9%-45.3% reclassified as normal or high-normal). The prevalence of reclassification increased with the magnitude of change between readings.

Conclusion: There is major individual variation of within-visit SBP change in childhood and adulthood and can influence BP classification. This highlights the importance of consistency among guidelines recommending that repeat BP measurements are needed for BP classification.

Item Details

Item Type:Refereed Article
Keywords:blood pressure, hypertension, public health, blood pressure classification, clinic blood pressure, hypertension guidelines, longitudinal study
Research Division:Biomedical and Clinical Sciences
Research Group:Cardiovascular medicine and haematology
Research Field:Cardiology (incl. cardiovascular diseases)
Objective Division:Health
Objective Group:Clinical health
Objective Field:Diagnosis of human diseases and conditions
UTAS Author:Meng, Y (Miss Yaxing Meng)
UTAS Author:Magnussen, CG (Associate Professor Costan Magnussen)
UTAS Author:Wu, F (Dr Feitong Wu)
UTAS Author:Buscot, M-J (Dr Marie-Jeanne Buscot)
UTAS Author:Sharman, JE (Professor James Sharman)
ID Code:153011
Year Published:2022
Web of Science® Times Cited:1
Deposited By:Menzies Institute for Medical Research
Deposited On:2022-09-01
Last Modified:2022-11-28
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