TY - JOUR
T1 - Predicting stroke using 4 ambulatory blood pressure monitoring-derived blood pressure indices
T2 - The Ohasama study
AU - Inoue, Ryusuke
AU - Ohkubo, Takayoshi
AU - Kikuya, Masahiro
AU - Metoki, Hirohito
AU - Asayama, Kei
AU - Obara, Taku
AU - Hoshi, Haruhisa
AU - Hashimoto, Junichiro
AU - Totsune, Kazuhito
AU - Satoh, Hiroshi
AU - Kondo, Yoshiaki
AU - Imai, Yutaka
PY - 2006/11
Y1 - 2006/11
N2 - We investigated the association between stroke and blood pressure (BP) indices (systolic BP [SBP], diastolic BP [DBP], mean BP [MBP], and pulse pressure [PP]) determined by ambulatory BP monitoring. The predictive power for stroke of these indices was compared in the general Japanese population. We obtained ambulatory BP data in 1271 subjects (40% men) aged ≥40 (mean: 61) years. During a mean follow-up of 11 years, 113 strokes were observed. The multivariate adjusted relative hazard and likelihood ratio for a 1-SD increase for each BP index was determined by Cox proportional hazard regression. Comparison of the likelihood ratio between Cox models including 2 indices and those including 1 index indicated that PP was significantly less informative than other indices (P<0.01 when adding MBP, SBP, or DBP to the PP model; P>0.09 when adding PP to the model including another index). However, after removing age from covariates, PP became more informative than DBP and MBP (P<0.0001 when adding PP to the MBP or DBP model, whereas SBP was more informative than PP even after removing age; P<0.05 when adding SBP to the PP model). In conclusion, PP was the weakest predictor of stroke. Exclusion of age from covariates increased the predictive power of PP, suggesting that the stroke risk associated with PP reflected the risk of aging per se.
AB - We investigated the association between stroke and blood pressure (BP) indices (systolic BP [SBP], diastolic BP [DBP], mean BP [MBP], and pulse pressure [PP]) determined by ambulatory BP monitoring. The predictive power for stroke of these indices was compared in the general Japanese population. We obtained ambulatory BP data in 1271 subjects (40% men) aged ≥40 (mean: 61) years. During a mean follow-up of 11 years, 113 strokes were observed. The multivariate adjusted relative hazard and likelihood ratio for a 1-SD increase for each BP index was determined by Cox proportional hazard regression. Comparison of the likelihood ratio between Cox models including 2 indices and those including 1 index indicated that PP was significantly less informative than other indices (P<0.01 when adding MBP, SBP, or DBP to the PP model; P>0.09 when adding PP to the model including another index). However, after removing age from covariates, PP became more informative than DBP and MBP (P<0.0001 when adding PP to the MBP or DBP model, whereas SBP was more informative than PP even after removing age; P<0.05 when adding SBP to the PP model). In conclusion, PP was the weakest predictor of stroke. Exclusion of age from covariates increased the predictive power of PP, suggesting that the stroke risk associated with PP reflected the risk of aging per se.
KW - Ambulatory blood pressure monitoring
KW - Diastolic blood pressure
KW - Mean blood/arterial pressure
KW - Pulse pressure
KW - Stroke
KW - Systolic blood pressure
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U2 - 10.1161/01.HYP.0000242285.83728.ee
DO - 10.1161/01.HYP.0000242285.83728.ee
M3 - Article
C2 - 16982961
AN - SCOPUS:33750233740
VL - 48
SP - 877
EP - 882
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 5
ER -