Predicting stroke using 4 ambulatory blood pressure monitoring-derived blood pressure indices: The Ohasama study

Ryusuke Inoue, Takayoshi Ohkubo, Masahiro Kikuya, Hirohito Metoki, Kei Asayama, Taku Obara, Haruhisa Hoshi, Junichiro Hashimoto, Kazuhito Totsune, Hiroshi Satoh, Yoshiaki Kondo, Yutaka Imai

Research output: Contribution to journalArticlepeer-review

34 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)877-882
Number of pages6
JournalHypertension
Volume48
Issue number5
DOIs
Publication statusPublished - 2006 Nov

Keywords

  • Ambulatory blood pressure monitoring
  • Diastolic blood pressure
  • Mean blood/arterial pressure
  • Pulse pressure
  • Stroke
  • Systolic blood pressure

ASJC Scopus subject areas

  • Internal Medicine

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