Cardiovascular prognostic value of ambulatory blood pressure monitoring in a Portuguese hypertensive population followed up for 8.2 years

• Type: Article in International Scientific Journal
• Date: 2010

Authors

Jose Mesquita Bastos (Author) Other; Susana Bertoquini (Author) Other; Jorge Polonia (Author) FMUP

Journal

Title: Blood Pressure Monitoring

Vol. 15

Pages: 240-246

ISSN: 1359-5237

Publisher: Wolters Kluwer Health

Indexing

ISI Web of Knowledge - 22 Citations

Scopus - 21 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-003-25N

DOI: 10.1097/mbp.0b013e32833c8b08

Abstract (EN): Aim We investigated the cardiovascular (CV) prognostic value of 24-h ambulatory blood pressure (ABP) and blood pressure (BP) during the six 4-h periods of the 24-h ABP length in a cohort of 1200 Portuguese hypertensive patients (aged 51 +/- 12 years) without earlier CV events. Method The presence of CV events were followed for 9.833 patient years and analyzed using a cox hazard model. Results During the 15.2 (mean 8.2) years follow-up, there were 152 CV events (11% fatal) including 79 strokes and 52 coronary events. After adjustment for risk factors and office BP (OBP), a 1-standard deviation increment of 24-h, daytime and night-time systolic BP (SBP) significantly predicted any CV event with hazard ratios (HR) 1.41, 1.33 and 1.57, respectively, and stroke with HR 1.67, 1.58, 1.67, respectively (all P < 0.01), but not coronary events. Prognostic significance of these SBP values and of night-time ABP persisted after adjustment for diastolic BP and daytime ABP, respectively, whereas the opposite did not occur. SBP night-time fall (%) inversely predicted total CV events after adjustment for diastolic BP night-time fall. Among all six 4-h periods of 24-h, increment of SBP during the first 4 h of night-time was the most powerful predictor of any CV event (HR 1.64) and stroke (HR 2.02) (both P < 0.01) even after adjustment for daytime and 24-h BP. Conclusion In predicting CV events and stroke, ABP is superior to office BP, ABP systolic is superior to ABP diastolic, and night-time BP is superior to daytime BP particularly during the first 4 h of sleep. Blood Press Monit 15: 240-246 (C) 2010 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 7