Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk
2007 (English)In: Circulation, ISSN 0009-7322, E-ISSN 1524-4539, Vol. 115, no 16, 2145-2152 p.Article in journal (Refereed) Published
Background - Current diagnostic thresholds for ambulatory blood pressure ( ABP) mainly rely on statistical parameters derived from reference populations. We determined an outcome-driven reference frame for ABP measurement. Methods and Results - We performed 24-hour ABP monitoring in 5682 participants ( mean age 59.0 years; 43.3% women) enrolled in prospective population studies in Copenhagen, Denmark; Noorderkempen, Belgium; Ohasama, Japan; and Uppsala, Sweden. In multivariate analyses, we determined ABP thresholds, which yielded 10-year cardiovascular risks similar to those associated with optimal ( 120/80 mm Hg), normal ( 130/85 mm Hg), and high ( 140/90 mm Hg) blood pressure on office measurement. Over 9.7 years ( median), 814 cardiovascular end points occurred, including 377 strokes and 435 cardiac events. Systolic/diastolic thresholds for optimal ABP were 116.8/74.2 mm Hg for 24 hours, 121.6/78.9 mm Hg for daytime, and 100.9/65.3 mm Hg for nighttime. Corresponding thresholds for normal ABP were 123.9/76.8, 129.9/82.6, and 110.2/68.1 mm Hg, respectively, and those for ambulatory hypertension were 131.0/79.4, 138.2/86.4, and 119.5/70.8 mm Hg. After rounding, approximate thresholds for optimal ABP amounted to 115/75 mm Hg for 24 hours, 120/80 mm Hg for daytime, and 100/65 mm Hg for nighttime. Rounded thresholds for normal ABP were 125/75, 130/85, and 110/70 mm Hg, respectively, and those for ambulatory hypertension were 130/80, 140/85, and 120/70 mm Hg. Conclusions - Population-based outcome-driven thresholds for optimal and normal ABP are lower than those currently proposed by hypertension guidelines.
Place, publisher, year, edition, pages
2007. Vol. 115, no 16, 2145-2152 p.
blood pressure monitoring, ambulatory, blood pressure, hypertension, cardiovascular diseases, epidemiology
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:uu:diva-144905DOI: 10.1161/CIRCULATIONAHA.106.662254ISI: 000245919600010PubMedID: 17420350OAI: oai:DiVA.org:uu-144905DiVA: diva2:394677