Reference values for 24-hour ambulatory blood pressure monitoring based on a prognostic criterion: The Ohasama study

Takayoshi Ohkubo, Yutaka Imai, Ichiro Tsuji, Kenichi Nagai, Sadayoshi Ito, Hiroshi Satoh, Shigeru Hisamichi

Research output: Contribution to journalArticlepeer-review

168 Citations (Scopus)


Although reference values for ambulatory blood pressure (ABP) monitoring have been investigated in several population studies, these values were derived from cross-sectional observations and were based merely on the statistical distribution of blood pressure values. Therefore, we conducted a prospective cohort study to identify reference values for 24-hour ABP in relation to prognosis. We obtained measurements of 24-hour ABP for 1542 subjects (565 men) aged 40 years and over in a general population of a rural Japanese community and then followed-up their survival status. There were 117 deaths during the follow-up period (mean, 6.2 years). The association between baseline 24-hour ABP values and mortality, examined by the Cox proportional hazards regression model adjusted for possible confounding factors, showed a better fit with a second-degree equation than with a first-degree equation. On the basis of the results of this analysiS, we identified the following reference values as the optimal blood pressure ranges that predict the best prognosis: 120 to 133 mm Hg for systolic blood pressure and 65 to 78 mm Hg for diastolic blood pressure. 24-Hour ABP values > 134/79 mm Hg and < 119/64 mm Hg were related to increased risks for cardiovascular and noncardiovascular mortality, respectively. This is the first report to propose reference values for 24-hour ABP based on a prognostic criterion.

Original languageEnglish
Pages (from-to)255-259
Number of pages5
Issue number2
Publication statusPublished - 1998 Aug


  • Blood pressure, ambulatory
  • Japanese population
  • Mortality
  • Prospective Studies
  • Reference values

ASJC Scopus subject areas

  • Internal Medicine


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