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Factors affecting the use of cumulative sums in the analysis of circadian blood pressure

Lookup NU author(s): Professor Sir John BurnORCiD, Dr Andrew SimsORCiD, Professor Gary Ford, Emeritus Professor Alan MurrayORCiD


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The assessment of circadian blood pressure change by ambulatory blood pressure monitoring has potential as a predictor for cardiovascular events, but its evaluation is problematic due to the difficulty in defining day and night periods for individual subjects. The cumulative sums (cusums) method has the advantage of simplicity over mathematical modelling techniques and is reported to give more reproducible results than methods that use time-dependent sleep and wake periods. However, cusum parameters (cusum-derived circadian alteration magnitude (CDCAM) and cusum plot height (CPH)) are affected by the implementation of the method and by the quality of ambulatory blood pressure recordings. This study quantifies the effects of using interval blood pressure values, changing the time used for calculating the cusum plot slope (CPS) and using incomplete data recordings. Significant effects are reported in all cases. Using interval rather than recorded blood pressures causes a mean reduction in CPH and CDCAM of approximately 6%. Altering the CPS time by 1 h ( from 6 h) results in a mean change in CDCAM of approximately 7%. In recordings with hourly readings, the coefficient of variation in CPH and CDCAM ranges from 4% (one missing reading) to 13% (five missing readings).

Publication metadata

Author(s): Burn J, Sims AJ, Ford GA, Murray A

Publication type: Article

Publication status: Unknown

Journal: Physiological Measurement

Year: 2006

Volume: 27

Issue: 6

Pages: 529-538

Date deposited: 12/10/2011

ISSN (print): 0967-3334

ISSN (electronic): 1361-6579

Publisher: Institute of Physics Publishing Ltd.


DOI: 10.1088/0967-3334/27/6/006


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