{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T22:23:06Z","timestamp":1788992586062,"version":"build-2803163510"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Beat\u2010to\u2010beat blood pressure variability (BPV) is associated with an increased risk of stroke but can be driven by both healthy physiological processes and failure of compensatory mechanisms. Blood pressure (BP) complexity measures structured, organized variations in BP, as opposed to random fluctuations, and its reduction may therefore identify pathological beat\u2010to\u2010beat BPV.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In the prospective, population\u2010based OXVASC (Oxford Vascular Study) Phenotyped Cohort with transient ischemic attack or minor stroke, patients underwent at least 5\u00a0minutes of noninvasive beat\u2010to\u2010beat monitoring of BP (Finometer) and ECG to derive the following: BPV (coefficient of variation) and complexity (modified multiscale entropy) of systolic BP and diastolic BP, heart rate variability (SD of R\u2010R intervals), and baroreflex sensitivity (BRS; Welch's method), in low\u2010 (0.04\u20130.15\u00a0Hz) and high\u2010frequency (0.15\u20130.4\u00a0Hz) bands. Associations between BPV or BP complexity with autonomic indexes and arterial stiffness were determined (linear regression), unadjusted, and adjusted for age, sex, and cardiovascular risk factors. In 908 consecutive, consenting patients, BP complexity was inversely correlated with BPV coefficient of variation (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and was similarly reduced in patients with hypertension or diabetes (\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). However, although BPV coefficient of variation had a U\u2010shaped relationship with age, BP complexity fell systematically across age quintiles (quintile 1: 15.1 [14.0\u201316.1] versus quintile 5: 13.8 [12.4\u201315.1]) and was correlated with markers of autonomic dysfunction (heart rate variability SD of R\u2010R intervals:\n              <jats:italic>r<\/jats:italic>\n              \u00a0=\u00a00.20; BRS low frequency: 0.19; BRS high frequency: 0.26) and arterial stiffness (pulse wave velocity: \u22120.21; all\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), even after adjustment for clinical variables (heart rate variability SD of R\u2010R intervals: 0.12; BRS low frequency and BRS high frequency: 0.13 and 0.17; and pulse wave velocity: \u22120.07; all\n              <jats:italic>P<\/jats:italic>\n              &lt;0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Loss of BP complexity discriminates BPV because of pathological failure of compensatory mechanisms and may represent a less confounded and potentially modifiable risk factor for stroke.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.022865","type":"journal-article","created":{"date-parts":[[2022,1,19]],"date-time":"2022-01-19T10:36:52Z","timestamp":1642588612000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Blood Pressure Complexity Discriminates Pathological Beat\u2010to\u2010Beat Variability as a Marker of Vascular Aging"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4060-2930","authenticated-orcid":false,"given":"Yun\u2010Kai","family":"Lee","sequence":"first","affiliation":[{"name":"Institute of Biomedical Engineering Department of Engineering Science University of Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1582-6724","authenticated-orcid":false,"given":"Sara","family":"Mazzucco","sequence":"additional","affiliation":[{"name":"Wolfson Centre for Prevention of Stroke and DementiaNuffield Department of Clinical NeurosciencesJohn Radcliffe HospitalUniversity of Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9739-9211","authenticated-orcid":false,"given":"Peter M.","family":"Rothwell","sequence":"additional","affiliation":[{"name":"Wolfson Centre for Prevention of Stroke and DementiaNuffield Department of Clinical NeurosciencesJohn Radcliffe HospitalUniversity of Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1156-2810","authenticated-orcid":false,"given":"Stephen J.","family":"Payne","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Engineering Department of Engineering Science University of Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0630-8204","authenticated-orcid":false,"given":"Alastair J. 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