Ambulatory Hypertension Subtypes and 24-Hour Systolic and Diastolic Blood Pressure as Distinct Outcome Predictors in 8341 Untreated People Recruited From 12 Populations

Yan Li, Fang-Fei Wei, Lutgarde Thijs, Jose Boggia, Kei Asayama, Tine W. Hansen, Masahiro Kikuya, Kristina Bjoerklund-Bodegard, Takayoshi Ohkubo, Jorgen Jeppesen, Yu-Mei Gu, Christian Torp-Pedersen, Eamon Dolan, Yan-Ping Liu, Tatiana Kuznetsova, Katarzyna Stolarz-Skrzypek, Valerie Tikhonoff, Sofia Malyutina, Edoardo Casiglia, Yuri NikitinLars Lind, Edgardo Sandoya, Kalina Kawecka-Jaszcz, Luis Mena, Gladys E. Maestre, Jan Filipovsky, Yutaka Imai, Eoin O'Brien, Ji-Guang Wang, Jan A. Staessen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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
Original languageEnglish
Pages (from-to)466–474
Issue number6
Publication statusPublished - 5 Aug 2014


  • ambulatory blood pressure monitoring
  • blood pressure component
  • cardiovascular diseases
  • population

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