Title: Thresholds for conventional and home blood pressure by sex and age in 5018 participants from 5 populations
Authors: Nomura, Kyoko ×
Asayama, Kei
Thijs, Lutgarde
Niiranen, Teemu J
Lujambio, Inés
Boggia, José
Hozawa, Atsushi
Ohkubo, Takayoshi
Hara, Azusa
Johansson, Jouni K
Sandoya, Edgardo
Kollias, Anastasios
Stergiou, George S
Tsuji, Ichiro
Jula, Antti M
Imai, Yutaka
Staessen, Jan A
International Database of Home Blood Pressure in Relation to Cardiovascular Outcome Investigators #
Issue Date: Oct-2014
Publisher: Lippincott Williams & Wilkins
Series Title: Hypertension vol:64 issue:4 pages:695-701
Article number: 10.1161/HYPERTENSIONAHA.114.03839
Abstract: Whether blood pressure thresholds for hypertension should differ according to sex or age remains debated. We did a subject-level meta-analysis of 5018 people untreated for hypertension and randomly recruited from 5 populations (women, 56.7%; ≥60 years, 42.3%). We used multivariable-adjusted Cox regression and a bootstrap procedure to determine home blood pressure (HBP) levels yielding 10-year cardiovascular risks similar to those associated with established systolic/diastolic thresholds (140-160/80-100 mm Hg) for the conventional blood pressure (CBP). Conversely, we estimated CBP thresholds providing 10-year cardiovascular risks similar to those associated established HBP levels (125-135/80-85 mm Hg). All analyses were stratified for sex and age (<60 versus ≥60 years). During 8.3 years (median), 414 participants experienced a cardiovascular event. The sex differences between HBP thresholds derived from CBP and between CBP thresholds derived from HBP were all nonsignificant (P≥0.24), ranging from -4.6 to 3.6 mm Hg systolic and from -4.3 to 2.1 mm Hg diastolic. The age differences between HBP thresholds derived from CBP and between CBP thresholds derived from HBP ranged from -6.7 to 8.4 mm Hg systolic and from -1.9 to 1.7 mm Hg diastolic and were nonsignificant (P≥0.08), except for HBP thresholds derived from CBP levels of 140 mm Hg systolic and 80 mm Hg diastolic (P≤0.04). Sensitivity analyses based on cardiac or cerebrovascular complications were confirmatory. In conclusion, our findings based on outcome-driven criteria support contemporary guidelines that propose single blood pressure thresholds that can be indiscriminately applied in both sexes and across the age range.
ISSN: 0194-911X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Department of Cardiovascular Sciences - miscellaneous
Hypertension and Cardiovascular Epidemiology
× corresponding author
# (joint) last author

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