uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations
Show others and affiliations
2014 (English)In: Hypertension, ISSN 0194-911X, E-ISSN 1524-4563, Vol. 63, no 2, 229-237 p.Article in journal (Refereed) Published
Abstract [en]

Evidence-based thresholds for risk stratification based on pulse pressure (PP) are currently unavailable. To derive outcome-driven thresholds for the 24-hour ambulatory PP, we analyzed 9938 participants randomly recruited from 11 populations (47.3% women). After age stratification (<60 versus >= 60 years) and using average risk as reference, we computed multivariable-adjusted hazard ratios (IIRs) to assess risk by tenths of the PP distribution or risk associated with stepwise increasing (+1 mm Hg) PP levels. All adjustments included mean arterial pressure. Among 6028 younger participants (68 853 person-years), the risk of cardiovascular (HR, 1.58; P=0.011) or cardiac (HR, 1.52; P=0.056) events increased only in the top PP tenth (mean, 60.6 mm Hg). Using stepwise increasing PP levels, the lower boundary of the 95% confidence interval of the successive thresholds did not cross unity. Among 3910 older participants (39 923 person-years), risk increased (P <= 0.028) in the top PP tenth (mean, 76.1 mm Hg). HRs were 1.30 and 1.62 for total and cardiovascular mortality, and 1.52, 1.69, and 1.40 for all cardiovascular, cardiac, and cerebrovascular events. The lower boundary of the 95% confidence interval of the HRs associated with stepwise increasing PP levels crossed unity at 64 mm Hg. While accounting for all covariables, the top tenth of PP contributed less than 0.3% (generalized R-2 statistic) to the overall risk among the elderly. Thus, in randomly recruited people, ambulatory PP does not add to risk stratification below age 60; in the elderly, PP is a weak risk factor with levels below 64 mm Hg probably being innocuous.

Place, publisher, year, edition, pages
2014. Vol. 63, no 2, 229-237 p.
Keyword [en]
ambulatory blood pressure, epidemiology, population science, pulse pressure
National Category
Cardiac and Cardiovascular Systems
URN: urn:nbn:se:uu:diva-228567DOI: 10.1161/HYPERTENSIONAHA.113.02179ISI: 000337284500016OAI: oai:DiVA.org:uu-228567DiVA: diva2:734394
Available from: 2014-07-17 Created: 2014-07-16 Last updated: 2014-07-17Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full text

Search in DiVA

By author/editor
Lind, Lars
By organisation
Cardiovascular epidemiologyGeriatrics
In the same journal
Cardiac and Cardiovascular Systems

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 256 hits
ReferencesLink to record
Permanent link

Direct link