Defining Thresholds for Home Blood Pressure Monitoring in Octogenarians

• Published in: Hypertension (Dallas, Tex. 1979) Tex. 1979), 2015-10, Vol.66 (4), p.865-873
• Main Authors: Aparicio, Lucas S, Thijs, Lutgarde, Boggia, José, Jacobs, Lotte, Barochiner, Jessica, Odili, Augustine N, Alfie, José, Asayama, Kei, Cuffaro, Paula E, Nomura, Kyoko, Ohkubo, Takayoshi, Tsuji, Ichiro, Stergiou, George S, Kikuya, Masahiro, Imai, Yutaka, Waisman, Gabriel D, Staessen, Jan A
• Format: Article
• Language: English
• Subjects: Aged, 80 and over; Blood Pressure - physiology; Blood Pressure Monitoring, Ambulatory - methods; Female; Follow-Up Studies; Global Health; Humans; Hypertension - diagnosis; Hypertension - epidemiology; Hypertension - physiopathology; Incidence; Male; Prognosis; Retrospective Studies; Risk Assessment - methods; Risk Factors
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/HYPERTENSIONAHA.115.05800

To generate outcome-driven thresholds for home blood pressure (BP) in the elderly, we analyzed 375 octogenarians (60.3% women; 83.0 years [mean]) enrolled in the International Database on home BP in relation to cardiovascular outcome. Over 5.5 years (median), 155 participants died, 76 from cardiovascular causes, whereas 104, 55, 36, and 51 experienced a cardiovascular, cardiac, coronary, or cerebrovascular event, respectively. In 202 untreated participants, home diastolic in the lowest fifth of the distribution (≤65.1 mm Hg) compared with the multivariable-adjusted average risk was associated with increased risk of cardiovascular mortality and morbidity (hazard ratios [HRs], ≥1.96; P≤0.022), whereas the HR for cardiovascular mortality in the top fifth (≥82.0 mm Hg) was 0.37 (P=0.034). Among 173 participants treated for hypertension, the HR for total mortality in the lowest fifth of systolic home BP (