Prediction of mortality by ambulatory blood pressure monitoring versus screening blood pressure measurements

Ohkubo, Takayoshi; Imai, Yutaka; Tsuji, Ichiro; Nagai, Kenichi; Watanabe, Noriko; Minami, Naoyoshi; Itoh, Osamu; Bando, Takehiko; Sakuma, Masayoshi; Fukao, Akira; Satoh, Hiroshi; Hisamichi, Shigeru; Abe, Keishi

doi:10.1097/00004872-199715040-00006

Cited by 229 publications

(155 citation statements)

References 28 publications

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“…The independent prognostic value of ambulatory BP, which was also confirmed in the present study, has been demonstrated by several previous investigators. [1][2][3][4] However, ambulatory BP monitoring is primarily used to evaluate risk in subjects with known office hypertension. Whereas white-coat hypertension has been subject to numerous investigations during previous years, the knowl- edge about the opposite phenomenon, isolated ambulatory hypertension, is limited.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Although 24-hour ambulatory BP recordings more accurately reflect the 24-hour BP load imposed on the vascular bed, most commonly, risk assessment in clinical practice and evaluation of antihypertensive treatment effect in clinical trials are based on conventional office BP monitoring. When there is a discrepancy between office and ambulatory BP, as in white-coat hypertension, the prognosis has been suggested to be more closely related to ambulatory BP.…”

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confidence: 99%

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Isolated Ambulatory Hypertension Predicts Cardiovascular Morbidity in Elderly Men

et al. 2003

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Background-Little is known about isolated ambulatory hypertension, a state with elevated ambulatory but normal office blood pressure (BP). This study aimed to investigate the prognostic significance of isolated ambulatory hypertension for cardiovascular morbidity in a population of elderly men. Methods and Results-At baseline, 24-hour ambulatory BP and metabolic and cardiac risk profiles were evaluated in 578 untreated 70-year-old men, participants of a population-based cohort. Subjects with isolated ambulatory hypertension (office BP Ͻ140/90 and daytime BP Ն135/85) and sustained hypertension (office BP Ն140/90 and daytime BP Ն135/85) had increased plasma glucose, body mass index, and echocardiographically determined left ventricular relative wall thickness compared with normotensive subjects (office BP Ͻ140/90 and daytime BP Ͻ135/85). Seventy-two cardiovascular morbid events (2.37 per 100 person-years at risk) occurred over 8.

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Isolated Ambulatory Hypertension Predicts Cardiovascular Morbidity in Elderly Men

et al. 2003

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“…4 -6 So far, only 1 large study has examined the prognostic value of ambulatory BP in a general population, the Ohasama study, conducted in a Japanese population, found future cardiovascular deaths to be better predicted by ambulatory BP than office BP. 7,8 In 1993 to 1994, we recorded ambulatory BP in a random sample of 1700 men and women from the general Danish population. Survival status was recorded until October 2003, allowing us to study the relationship between ambulatory BP and mortality in a general Western population for the first time.…”

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Ambulatory Blood Pressure and Mortality

et al. 2005

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Abstract-The relationship between ambulatory blood pressure and mortality in a general Western population is unknown.Therefore, we conducted this prospective study of a random sample of 1700 Danish men and women, aged 41 to 72 years, without major cardiovascular diseases. At baseline, ambulatory blood pressure, office blood pressure, and other risk factors were recorded. After a mean period of 9.5 years, 174 had died: 63 were cardiovascular deaths. In multivariate proportional hazards models, adjusted for other risk factors of significance, the relative risk of cardiovascular mortality (95% confidence interval) associated with 10 mm Hg increments in systolic and 5 mm Hg increments in diastolic ambulatory blood pressure were 1.51 (1.28 to 1.77) and 1.43 (1.26 to 1.61). The corresponding figures for all cause mortality were 1.18 (1.06 to 1.31) and 1.18 (1.09 to 1.28). The relative risks of cardiovascular mortality were lower for office blood pressure, and office blood pressure did not predict all cause mortality. When ambulatory and office blood pressures were entered in the same multivariate models, only the ambulatory blood pressures were significant predictors of all cause mortality and cardiovascular mortality. The relationship between ambulatory blood pressures and risk of mortality was log-linear, with no indication of a threshold. The absolute risk of mortality was also dependent on age and smoking status, and an upper "acceptable" ambulatory blood pressure based on risk of mortality could only be defined when other risk factors were taken into account. In conclusion, ambulatory blood pressure provided prognostic information on mortality above and beyond that of office blood pressure.

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“…Ademais, Gould e col verificaram que os valores de pressão intra-arterial também se correlacionam melhor com as medidas realizadas em casa do que com as medidas do consultório 7 . Além disso, também foi demonstrado que as medidas da pressão em casa correlacionam-se melhor com mortalidade do que as medidas de consultório 8 .…”

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Monitorização residencial da pressão arterial e monitorização ambulatorial da pressão arterial versus medida de pressão arterial no consultório

Gomes¹,

Pierin²,

Segre³

et al. 1998

Arq. Bras. Cardiol.

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Purpose -To compare both home blood pressure measurement (HBPM) and ambulatory blood pressure monitoring (ABPM) with office blood pressure measurement (OBP); and also to compare the correlation between HBPM and OBP with LVMI (left ventricular mass index).Methods (r= 0.39 / 0.49, p<0.05, systolic and diastolic, respectively) than OBP (r= 0.02/ 0.22, p>0.05, systolic and diastolic, respectively). Conclusion -This study showed that HBPM has a better correlation with LVMI than OBP. Key Monitorização Residencial da Pressão Arterial e Monitorização Ambulatorial da Pressão Arterial versus Medida de Pressão Arterial no Consultório Artigo OriginalPara o diagnóstico da hipertensão arterial (HA) na prá-tica clínica, o médico mede a pressão arterial (PA) no consultório, empregando método indireto e técnica auscultatória. No entanto, apesar de ser o método mais freqüentemente utilizado, tem sido demonstrado que a própria presença do médico pode influenciar a leitura obtida da PA 1 .Esta influência começou a ser estudada em 1940 por Ayman e Goldshine 2 ao constatarem que os valores da medida realizada em casa eram inferiores aos obtidos no consultório, provavelmente devido à excitação provocada pela presença do médico. Mais recentemente, foi demonstrado em pacientes com a pressão monitorizada intra-arterialmente que a pressão intra-arterial se eleva no momento que o médico realiza a medida da pressão pelo método indireto com técnica auscultatória 1 . Esta reação frente à medida da

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Prediction of mortality by ambulatory blood pressure monitoring versus screening blood pressure measurements

Cited by 229 publications

References 28 publications

Isolated Ambulatory Hypertension Predicts Cardiovascular Morbidity in Elderly Men

Isolated Ambulatory Hypertension Predicts Cardiovascular Morbidity in Elderly Men

Ambulatory Blood Pressure and Mortality

Monitorização residencial da pressão arterial e monitorização ambulatorial da pressão arterial versus medida de pressão arterial no consultório

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