title: A cyclic fluctuation model for 24-h ambulatory blood pressure monitoring in Chinese patients with mild to moderate hypertension.
abstract: OBJECTIVE
  The conventional method for analyzing 24-h ambulatory blood pressure monitoring (24-h ABPM) is insufficient to deal with the large amount of data collected. The aim of this study was to develop a novel cyclic fluctuation model for 24-h ABPM in Chinese patients with mild to moderate hypertension.
  
  
  METHODS
  The data were obtained from 4 independent antihypertensive drug clinical trials in Chinese patients with mild to moderate hypertension. The measurements of 24-h ABPM at the end of the placebo run-in period in study 1 were used to develop the cyclic fluctuation model. After evaluated, the structural model was used to analyze the measurements in the other 3 studies. Models were fitted using NONMEM software.
  
  
  RESULTS
  The cyclic fluctuation model, which consisted of 2 cosine functions with fixed-effect parameters for rhythm-adjusted 24-h mean blood pressure, amplitude and phase shift, successfully described the blood pressure measurements of study 1. Model robustness was validated by the bootstrap method. The measurements in the other 3 studies were well described by the same structural model. Moreover, the parameters from all the 4 studies were very similar. Visual predictive checks demonstrated that the cyclic fluctuation model could predict the blood pressure fluctuations in the 4 studies.
  
  
  CONCLUSIONS
  The cyclic fluctuation model for 24-h ABPM deepens our understanding of blood pressure variability, which will be beneficial for drug development and individual therapy in hypertensive patients.
authors.affiliation: Center for Drug Clinical Research, Shanghai University of Chinese Medicine, Shanghai 201203, China.
authors.forename: Yu-cheng
authors.initials: YC
authors.lastname: Sheng
authors.forename: Kun
authors.initials: K
authors.lastname: Wang
authors.forename: Ling
authors.initials: L
authors.lastname: Xu
authors.forename: Juan
authors.initials: J
authors.lastname: Yang
authors.forename: Ying-chun
authors.initials: YC
authors.lastname: He
authors.forename: Qing-shan
authors.initials: QS
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People / Q000208:ethnology*; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D002940:Circadian Rhythm / Q000502:physiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged