Pulse lineResearch With Heart Logo

Methods to estimate underlying blood pressure: The Atherosclerosis Risk in Communities (ARIC) Study.

TitleMethods to estimate underlying blood pressure: The Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsBalakrishnan P, Beaty T, Young HJ, Colantuoni E
Secondary AuthorsMatsushita K
JournalPLoS One
Volume12
Issue7
Paginatione0179234
Date Published2017
ISSN1932-6203
KeywordsAntihypertensive Agents, Atherosclerosis, Blood Pressure, Blood Pressure Determination, Female, Humans, Hypertension, Male, Middle Aged
Abstract

Antihypertensive medications complicate studies of blood pressure (BP) natural history; BP if untreated ("underlying BP") needs to be estimated. Our objectives were to compare validity of five missing data imputation methods to estimate underlying BP and longitudinal associations of underlying BP and age. We simulated BP treatment in untreated hypertensive participants from Atherosclerosis Risk in Communities (ARIC) in visits 1-5 (1987-2013) using matched treated hypertensive participants. The underlying BP was imputed: #1, set as missing; #2, add 10 mmHg for systolic, 5 mmHg for diastolic; #3, add medication class-specific constant; #4, truncated normal regression; and #5, truncated normal regression including prior visit data. Longitudinal associations were estimated using linear mixed models of imputed underlying BP for simulated treated and measured BP for untreated participants. Method 3 was the best-performing for systolic BP; lowest relative bias (5.3% for intercept at age 50, 0% for age coefficient) and average deviation from expected (0.04 to -1.79). Method 2 performed best for diastolic BP; lowest relative bias (0.6% intercept at age 50, 33.3% age

DOI10.1371/journal.pone.0179234
Alternate JournalPLoS One
PubMed ID28700596
PubMed Central IDPMC5507409
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
T32 ES007141 / ES / NIEHS NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States