Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations

Yu-Mei Gu; Lutgarde Thijs; Yan Li; Kei Asayama; Jose Boggia; Tine W. Hansen; Yan-Ping Liu; Takayoshi Ohkubo; Krishna Bjorklund-Bodegard; Jorgen Jeppesen; Eamon Dolan; Christian Torp-Pedersen; Tatiana Kuznetsova; Katarzyna Stolarz-Skrzypek; Valerie Tikhonoff; Sofia Malyutina; Edoardo Casiglia; Yuri Nikitin; Lars Lind; Edgardo Sandoya; Kalina Kawecka-Jaszcz; Yutaka Imai; Luis J. Mena; Jiguang Wang; Eoin O'Brien; Peter Verhamme; Jan Filipovsky; Gladys E. Maestre; Jan A. Staessen

doi:10.1161/HYPERTENSIONAHA.113.02179

Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations

Yu-Mei Gu, Lutgarde Thijs, Yan Li, Kei Asayama, Jose Boggia, Tine W. Hansen, Yan-Ping Liu, Takayoshi Ohkubo, Krishna Bjorklund-Bodegard, Jorgen Jeppesen, Eamon Dolan, Christian Torp-Pedersen, Tatiana Kuznetsova, Katarzyna Stolarz-Skrzypek, Valerie Tikhonoff, Sofia Malyutina, Edoardo Casiglia, Yuri Nikitin, Lars Lind, Edgardo SandoyaKalina Kawecka-Jaszcz, Yutaka Imai, Luis J. Mena, Jiguang Wang, Eoin O'Brien, Peter Verhamme, Jan Filipovsky, Gladys E. Maestre, Jan A. Staessen^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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 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

Original language	English
Pages (from-to)	229–237
Journal	Hypertension
Volume	63
Issue number	2
DOIs	https://doi.org/10.1161/HYPERTENSIONAHA.113.02179
Publication status	Published - Feb 2014

Keywords

ambulatory blood pressure
epidemiology
population science
pulse pressure

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10.1161/HYPERTENSIONAHA.113.02179

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Gu, Y.-M., Thijs, L., Li, Y., Asayama, K., Boggia, J., Hansen, T. W., Liu, Y.-P., Ohkubo, T., Bjorklund-Bodegard, K., Jeppesen, J., Dolan, E., Torp-Pedersen, C., Kuznetsova, T., Stolarz-Skrzypek, K., Tikhonoff, V., Malyutina, S., Casiglia, E., Nikitin, Y., Lind, L., ... Staessen, J. A. (2014). Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations. Hypertension, 63(2), 229–237. https://doi.org/10.1161/HYPERTENSIONAHA.113.02179

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title = "Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations",

abstract = "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 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 ",

keywords = "ambulatory blood pressure, epidemiology, population science, pulse pressure",

author = "Yu-Mei Gu and Lutgarde Thijs and Yan Li and Kei Asayama and Jose Boggia and Hansen, {Tine W.} and Yan-Ping Liu and Takayoshi Ohkubo and Krishna Bjorklund-Bodegard and Jorgen Jeppesen and Eamon Dolan and Christian Torp-Pedersen and Tatiana Kuznetsova and Katarzyna Stolarz-Skrzypek and Valerie Tikhonoff and Sofia Malyutina and Edoardo Casiglia and Yuri Nikitin and Lars Lind and Edgardo Sandoya and Kalina Kawecka-Jaszcz and Yutaka Imai and Mena, {Luis J.} and Jiguang Wang and Eoin O'Brien and Peter Verhamme and Jan Filipovsky and Maestre, {Gladys E.} and Staessen, {Jan A.}",

year = "2014",

month = feb,

doi = "10.1161/HYPERTENSIONAHA.113.02179",

language = "English",

volume = "63",

pages = "229–237",

journal = "Hypertension",

issn = "0194-911X",

publisher = "Lippincott Williams & Wilkins",

number = "2",

}

Gu, Y-M, Thijs, L, Li, Y, Asayama, K, Boggia, J, Hansen, TW, Liu, Y-P, Ohkubo, T, Bjorklund-Bodegard, K, Jeppesen, J, Dolan, E, Torp-Pedersen, C, Kuznetsova, T, Stolarz-Skrzypek, K, Tikhonoff, V, Malyutina, S, Casiglia, E, Nikitin, Y, Lind, L, Sandoya, E, Kawecka-Jaszcz, K, Imai, Y, Mena, LJ, Wang, J, O'Brien, E, Verhamme, P, Filipovsky, J, Maestre, GE & Staessen, JA 2014, 'Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations', Hypertension, vol. 63, no. 2, pp. 229–237. https://doi.org/10.1161/HYPERTENSIONAHA.113.02179

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T1 - Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations

AU - Gu, Yu-Mei

AU - Thijs, Lutgarde

AU - Li, Yan

AU - Asayama, Kei

AU - Boggia, Jose

AU - Hansen, Tine W.

AU - Liu, Yan-Ping

AU - Ohkubo, Takayoshi

AU - Bjorklund-Bodegard, Krishna

AU - Jeppesen, Jorgen

AU - Dolan, Eamon

AU - Torp-Pedersen, Christian

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 - Imai, Yutaka

AU - Mena, Luis J.

AU - Wang, Jiguang

AU - O'Brien, Eoin

AU - Verhamme, Peter

AU - Filipovsky, Jan

AU - Maestre, Gladys E.

AU - Staessen, Jan A.

PY - 2014/2

Y1 - 2014/2

N2 - 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 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

AB - 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 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

KW - ambulatory blood pressure

KW - epidemiology

KW - population science

KW - pulse pressure

U2 - 10.1161/HYPERTENSIONAHA.113.02179

DO - 10.1161/HYPERTENSIONAHA.113.02179

M3 - Article

C2 - 24324050

SN - 0194-911X

VL - 63

SP - 229

EP - 237

JO - Hypertension

JF - Hypertension

IS - 2

ER -

Outcome-Driven Thresholds for Ambulatory Pulse Pressure in 9938 Participants Recruited From 11 Populations

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Keywords

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