Prediction of coronary and cerebrovascular morbidity and mortality by direct continuous ambulatory blood pressure monitoring in essential hypertension

The goal of this study was to assess the prognostic value of ambulatory versus clinic blood pressure measurement and to relate cardiovascular risk to ambulatory systolic and diastolic blood pressure levels. The study population consisted of 688 patients 51+/-11 years of age who had undergone pretrea...

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Published in:Circulation (New York, N.Y.) N.Y.), 1999-09, Vol.100 (10), p.1071-1076
Main Authors: KHATTAR, R. S, SWALES, J. D, BANFIELD, A, DORE, C, SENIOR, R, LAHIRI, A
Format: Article
Language:English
Subjects:
Adult
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure
Blood Pressure Monitoring, Ambulatory
Cardiology. Vascular system
Cardiovascular Diseases - etiology
Cerebrovascular Disorders - complications
Cerebrovascular Disorders - epidemiology
Cerebrovascular Disorders - etiology
Cerebrovascular Disorders - mortality
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Coronary Disease - epidemiology
Coronary Disease - etiology
Coronary Disease - mortality
Demography
Female
Hemodynamics
Humans
Hypertension - physiopathology
Incidence
Male
Medical sciences
Middle Aged
Morbidity
Prognosis
Risk Factors
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Summary:The goal of this study was to assess the prognostic value of ambulatory versus clinic blood pressure measurement and to relate cardiovascular risk to ambulatory systolic and diastolic blood pressure levels. The study population consisted of 688 patients 51+/-11 years of age who had undergone pretreatment 24-hour intra-arterial ambulatory blood pressure monitoring on the basis of elevated clinic blood pressure. A total of 157 first events were recorded during a 9.2+/-4.1-year follow-up period. The predictive value of a regression model containing age, sex, race, body mass index, smoking, diabetes mellitus, fasting cholesterol level, and previous history of cardiovascular disease was significantly improved by the addition of any ambulatory systolic or diastolic blood pressure parameter (whether 24-hour, daytime, or nighttime mean) or pulse pressure, whereas inclusion of baseline clinic blood pressure variables did not enhance the prediction of events. The most predictive models contained the ambulatory systolic blood pressure parameters. In the model containing 24-hour mean ambulatory systolic blood pressure (P=0.001), age (P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.cir.100.10.1071