Title: Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk
Authors: Kikuya, Masahiro
Hansen, Tine W
Thijs, Lutgarde
Björklund-Bodegård, Kristina
Kuznetsova, Tatiana
Ohkubo, Takayoshi
Richart, Tom
Torp-Pedersen, Christian
Lind, Lars
Ibsen, Hans
Imai, Yutaka
Staessen, Jan A # ×
Issue Date: Apr-2007
Publisher: Lippincott Williams & Wilkins
Series Title: Circulation vol:115 issue:16 pages:2145-2152
Abstract: Current diagnostic thresholds for ambulatory blood pressure (ABP) mainly rely on statistical parameters derived from reference populations. We determined an outcome-driven reference frame for ABP measurement. We performed 24-h ABP monitoring in 5682 participants (mean age 59.0 years; 43.3% women) enrolled in prospective population studies in Copenhagen, Denmark; Noorderkempen, Belgium; Ohasama, Japan; and Uppsala, Sweden. In multivariate analyses, we determined ABP thresholds, which yielded 10-year cardiovascular risks similar to those associated with optimal (120/80 mmHg), normal (130/85 mmHg), and high (140/90 mmHg) blood pressure on office measurement. Over 9.7 years (median), 814 cardiovascular end points occurred, including 377 strokes and 435 cardiac events. Systolic/diastolic thresholds for optimal ABP were 118.3/74.2 mmHg for 24 h, 121.6/78.9 mmHg for daytime, and 104.7/65.3 mmHg for nighttime. Corresponding thresholds for normal ABP were 124.3/76.8,129.9/82.6, and 111.6/68.1 mmHg, respectively, and those for ambulatory hypertension were 130.3/79.4, 138.2/86.4, and 118.5/70.8 mmHg. After rounding, approximate thresholds for optimal ABP amounted to 115/75 mmHg for 24 h, 120/80 mmHg for daytime, and 105/65 mmHg for nighttime. Rounded thresholds for normal ABP were 125/75,130/85, and 110/70 mmHg, respectively, and those for ambulatory hypertension were 130/80, 140/85, and 120/70 mmHg. In conclusion, population-based outcome-driven thresholds for optimal and normal ABP are lower than those currently proposed by hypertension guidelines.
ISSN: 0009-7322
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Cardiology
Hypertension and Cardiovascular Epidemiology
× corresponding author
# (joint) last author

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