Reference frame for home pulse pressure based on cardiovascular risk in 6470 subjects from 5 populations

Lucas S. Aparicio, Lutgarde Thijs, Kei Asayama, Jessica Barochiner, Jose Boggia, Yu-Mei Gu, Paula E. Cuffaro, Yan-Ping Liu, Teemu J. Niiranen, Takayoshi Ohkubo, Jouni K. Johansson, Masahiro Kikuya, Atsushi Hozawa, Ichiro Tsuji, Yutaka Imai, Edgardo Sandoya, George S. Stergiou, Gabriel D. Waisman, Jan A. Staessen*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

11 Citations (Web of Science)


The absence of an outcome-driven reference frame for self-measured pulse pressure (PP) limits its clinical applicability. In an attempt to derive an operational threshold for self-measured PP, we analyzed 6470 participants (mean age 59.3 years; 56.9% women; 22.5% on antihypertensive treatment) from 5 general population cohorts included in the International Database on HOme blood pressure in relation to Cardiovascular Outcome. During 8.3 years of follow-up (median), 294 cardiovascular deaths, 393 strokes and 336 cardiac events occurred. In 3285 younger subjects (= 60 years) PP predicted total and cardiovascular mortality (P = 76 mm Hg) versus the average risk in whole population were 1.41 (95% confidence interval, 1.09-1.81; P = 0.0081) for all-cause mortality, 1.62 (1.11-2.35; P = 0.012) for cardiovascular mortality and 1.31 (1.00-1.70; P = 0.047) for all fatal and nonfatal cardiovascular end points combined. The low number of events precluded an analysis by tenths of the PP distribution in younger participants. In conclusion, a home PP of >= 76 mm Hg predicted cardiovascular outcomes in the elderly with the exception of stroke, whereas in younger subjects no threshold could be established.
Original languageEnglish
Pages (from-to)672-678
JournalHypertension Research
Issue number7
Publication statusPublished - Jul 2014


  • cardiovascular diseases
  • epidemiology
  • home blood pressure
  • pulse pressure
  • thresholds

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