TY - JOUR
T1 - Ambulatory Hypertension Subtypes and 24-Hour Systolic and Diastolic Blood Pressure as Distinct Outcome Predictors in 8341 Untreated People Recruited From 12 Populations
AU - Li, Yan
AU - Wei, Fang-Fei
AU - Thijs, Lutgarde
AU - Boggia, Jose
AU - Asayama, Kei
AU - Hansen, Tine W.
AU - Kikuya, Masahiro
AU - Bjoerklund-Bodegard, Kristina
AU - Ohkubo, Takayoshi
AU - Jeppesen, Jorgen
AU - Gu, Yu-Mei
AU - Torp-Pedersen, Christian
AU - Dolan, Eamon
AU - Liu, Yan-Ping
AU - Kuznetsova, Tatiana
AU - Stolarz-Skrzypek, Katarzyna
AU - Tikhonoff, Valerie
AU - Malyutina, Sofia
AU - Casiglia, Edoardo
AU - Nikitin, Yuri
AU - Lind, Lars
AU - Sandoya, Edgardo
AU - Kawecka-Jaszcz, Kalina
AU - Mena, Luis
AU - Maestre, Gladys E.
AU - Filipovsky, Jan
AU - Imai, Yutaka
AU - O'Brien, Eoin
AU - Wang, Ji-Guang
AU - Staessen, Jan A.
PY - 2014/8/5
Y1 - 2014/8/5
N2 - Background-Data on risk associated with 24-hour ambulatory diastolic (DBP24) versus systolic (SBP24) blood pressure are scarce. Methods and Results-We recorded 24-hour blood pressure and health outcomes in 8341 untreated people (mean age, 50.8 years; 46.6% women) randomly recruited from 12 populations. We computed hazard ratios (HRs) using multivariable-adjusted Cox regression. Over 11.2 years (median), 927 (11.1%) participants died, 356 (4.3%) from cardiovascular causes, and 744 (8.9%) experienced a fatal or nonfatal cardiovascular event. Isolated diastolic hypertension (DBP24 >= 80 mm Hg) did not increase the risk of total mortality, cardiovascular mortality, or stroke (HRs = 0.18), but was associated with a higher risk of fatal combined with nonfatal cardiovascular, cardiac, or coronary events (HRs >= 1.75; P = 130 mm Hg) and mixed diastolic plus systolic hypertension were associated with increased risks of all aforementioned end points (P = 0.068); above age 50, SBP24 predicted all end points (HR >= 1.19; P = 0.10). The interactions of age with SBP24 and DBP24 were significant for all cardiovascular and coronary events (P
AB - Background-Data on risk associated with 24-hour ambulatory diastolic (DBP24) versus systolic (SBP24) blood pressure are scarce. Methods and Results-We recorded 24-hour blood pressure and health outcomes in 8341 untreated people (mean age, 50.8 years; 46.6% women) randomly recruited from 12 populations. We computed hazard ratios (HRs) using multivariable-adjusted Cox regression. Over 11.2 years (median), 927 (11.1%) participants died, 356 (4.3%) from cardiovascular causes, and 744 (8.9%) experienced a fatal or nonfatal cardiovascular event. Isolated diastolic hypertension (DBP24 >= 80 mm Hg) did not increase the risk of total mortality, cardiovascular mortality, or stroke (HRs = 0.18), but was associated with a higher risk of fatal combined with nonfatal cardiovascular, cardiac, or coronary events (HRs >= 1.75; P = 130 mm Hg) and mixed diastolic plus systolic hypertension were associated with increased risks of all aforementioned end points (P = 0.068); above age 50, SBP24 predicted all end points (HR >= 1.19; P = 0.10). The interactions of age with SBP24 and DBP24 were significant for all cardiovascular and coronary events (P
KW - ambulatory blood pressure monitoring
KW - blood pressure component
KW - cardiovascular diseases
KW - population
U2 - 10.1161/CIRCULATIONAHA.113.004876
DO - 10.1161/CIRCULATIONAHA.113.004876
M3 - Article
C2 - 24906822
SN - 0009-7322
VL - 130
SP - 466
EP - 474
JO - Circulation
JF - Circulation
IS - 6
ER -