Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations

T. W. Hansen, L. Thijs, Y. Li, J. Boggia, Y. Liu, K. Asayama, M. Kikuya, K. Bjorklund-Bodegard, T. Ohkubo, J. Jeppesen, C. Torp-Pedersen, E. Dolan, T. Kuznetsova, K. Stolarz-Skrzypek, V. Tikhonoff, S. Malyutina, E. Casiglia, Y. Nikitin, L. Lind, E. SandoyaK. Kawecka-Jaszcz, J. Filipovsky, Y. Imai, J. Wang, E. O'Brien, J. A. Staessen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.0% women) randomly recruited from 10 populations, we studied the contribution of body mass index (BMI) to risk over and beyond BP, taking advantage of the superiority of ambulatory over conventional BP. Over 10.6 years (median), 1271 participants (15.0%) died and 1092 (12.9%), 637 (7.5%) and 443 (5.2%) experienced a fatal or nonfatal cardiovascular, cardiac or cerebrovascular event. Adjusted for sex and age, low BMI (= 30.9 kg m(-2)) predicted the cardiovascular end point (HR, 1.27; P = 0.006). With adjustments including 24-h systolic BP, these HRs were 1.50 (P = 0.22). Excluding smokers removed the contribution of BMI categories to the prediction of mortality. In conclusion, BMI only adds to BP in risk stratification for mortality but not for cardiovascular outcomes. Smoking probably explains the association between increased mortality and low BMI.
Original languageEnglish
Pages (from-to)535-542
JournalJournal of Human Hypertension
Issue number9
Publication statusPublished - Sept 2014


  • ambulatory blood pressure
  • body mass index
  • population science
  • risk factors
  • epidemiology

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