Association of office and ambulatory blood pressure with mortality and cardiovascular outcomes
JAMA Aug 14, 2019
Yang WY, Melgarejo JD, Thijs L, et al. – In a population-based cohort of 11,135 adults, researchers assessed the correlation of blood pressure (BP) indexes with death and a composite cardiovascular (CV) event. Both endpoints were significantly correlated with all single systolic BP indexes. The HR for total mortality and for CV events was 1.23 and 1.36, and 1.22 and 1.45 for the nighttime systolic BP level and for the 24-hour systolic BP level, respectively. The relationship of the nighttime and 24-hour systolic BP with the primary outcomes continued to be statistically important, with adjustment for any of the other systolic BP indexes. Adding any systolic BP index to models already including nighttime or 24-hour systolic BP did not significantly increase model performance. These findings were constant for diastolic BP. Overall, even post-adjustments for other office-based or ambulatory blood pressure measurements, higher 24-hour, and nighttime blood pressure measurements were significantly linked to greater risks of death and a composite CV outcome. Therefore, for estimating CV risk, 24-hour and nighttime blood pressure may be optimal measurement;, however, statistically, a model improvement, when compared with other blood pressure indexes, was small.
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