Estimating the association between blood pressure variability and cardiovascular disease: An application using the ARIC Study.

ABSTRACT: The association between visit-to-visit systolic blood pressure variability and cardiovascular events has recently received a lot of attention in the cardiovascular literature. But, blood pressure variability is usually estimated on a person-by-person basis and is therefore subject to considerable measurement error. We demonstrate that hazard ratios estimated using this approach are subject to bias due to regression dilution, and we propose alternative methods to reduce this bias: a two-stage method and a joint model. For the two-stage method, in stage one, repeated measurements are modelled using a mixed effects model with a random component on the residual standard deviation (SD). The mixed effects model is used to estimate the blood pressure SD for each individual, which, in stage two, i

SUBMITTER: Barrett JK 

PROVIDER: S-EPMC6445736 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature