CORNELISSEN, Germaine, Jarmila SIEGELOVÁ, Yoshihiko WATANABE, Kuniaki OTSUKA and Franz HALBERG. Chronobiologically-Interpreted ABPM Reveals Another Vascular Variability Anomaly (VVA): Excessive Pulse Pressure Product (PPP) Updated Conference Report. World Heart Journal. Hauppauge, Spojené státy americké: Nova Science Publishers, 2012, vol. 4, No 4, p. 237-245. ISSN 1556-4002.
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Basic information
Original name Chronobiologically-Interpreted ABPM Reveals Another Vascular Variability Anomaly (VVA): Excessive Pulse Pressure Product (PPP) Updated Conference Report
Authors CORNELISSEN, Germaine (840 United States of America, guarantor), Jarmila SIEGELOVÁ (203 Czech Republic, belonging to the institution), Yoshihiko WATANABE (392 Japan), Kuniaki OTSUKA (392 Japan) and Franz HALBERG (840 United States of America).
Edition World Heart Journal, Hauppauge, Spojené státy americké, Nova Science Publishers, 2012, 1556-4002.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
RIV identification code RIV/00216224:14110/12:00069459
Organization unit Faculty of Medicine
Keywords in English Ambulatory Blood Pressure Monitoring; Cardiovascular Disease Risk; Outcome; Pulse Pressure Product (PPP); Vascular Variability Disorder (VVD)
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 25. 9. 2013 16:41.
Abstract
To assess the risk associated with an Excessive Pulse Pressure Product (EPPP, where PPP = systolic blood pressure x heart rate / 100), PPP was determined from Chronobiologically and chronomically interpreted aroundthe-clock Ambulatory Blood Pressure Monitoring (CABPM) and related to outcomes in three different investigations, carried out in the Czech Republic, Japan, and Taiwan. In these three outcome studies, values of PPP above 100 were associated with a statistically significant increase in cardiovascular disease risk. As such, EPPP in a 7-day or longer around-the-clock record qualifies as a new Vascular Variability Anomaly (VVA), or, if it persists in a series of 7-day records, a Vascular Variability Disorder (VVD). Being the product of blood pressure and heart rate, EPPP is not independent from MESOR-hypertension. The extent to which EPPP may contribute additive cardiovascular disease risk to other VVDs will require larger outcome studies capable of separating the risk associated with each VVD. In any event, PPP offers itself as another harbinger of risk, as a gauge for the optimization of treatment by timing, and as a variable with a time structure of its own, differing in terms of components with long periods found in time series covering decades from concomitantly measured systolic and diastolic blood pressure and heart rate. Since cardiovascular disease risk is dramatically increased by the co-existence of several VVAs (up to 100% in a 6-year prospective outcome study), sole reliance on the mean without consideration of other VVAs can no longer be forgiven as ignorance and should rather be viewed as indolence, eventually even as criminal negligence.
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