The present study compared the blood pressure variability (BPV) among
office (OBP), home (HBP), and ambulatory blood pressure (ABP)
measurements and assessed their determinants, as well as their agreement
in identifying individuals with high BPV. Individuals attending a
hypertension clinic had OBP measurements (2-3 visits) and underwent HBP
monitoring (3-7 days, duplicate morning and evening measurements) and
ABP monitoring (24 h, 20-min intervals). BPV was quantified using the
standard deviation (SD), coefficient of variation (CV), and variability
independent of the mean (VIM) using all BP readings obtained by each
method. A total of 626 participants were analyzed (age 52.8 +/- 12.0
years, 57.7% males, 33.1% treated). Systolic BPV was usually higher
than diastolic BPV, and out-of-office BPV was higher than office BPV,
with ambulatory BPV giving the highest values. BPV was higher in women
than men, yet it was not different between untreated and treated
individuals. Associations among BPV indices assessed using different
measurement methods were weak (r 0.1-0.3) but were stronger between
out-of-office BPV indices. The agreement between methods in detecting
individuals with high BPV was low (30-40%) but was higher between
out-of-office BPV indices. Older age was an independent determinant of
increased OBP variability. Older age, female sex, smoking, and
overweight/obesity were determinants of increased out-of-office BPV.
These data suggest that BPV differs with different BP measurement
methods, reflecting different pathophysiological phenomena, whereas the
selection of the BPV index is less important. Office and out-of-office
BP measurements appear to be complementary methods in assessing BPV