The ambulatory blood pressure in normotensive and hypertensive subjects: results from an international database

Lutgarde Thijs, Jan Staessen, Eoin O'Brien, Antoon Amery, Neil Atkins, Peter Baumgart, Paul De Cort, Jean Paul Degaute, Primoz Dolenc, Régis De Gaudemaris, Inger Enström, Robert Fagard, Philippe Gosse, Steve Gourlay, Hiroshi Hayashi, Yutaki Imai, Gary James, Teruo Kawasaki, Emilio Kuschnir, Iwao KuwajimaLars Lindholm, Lisheng Liu, Franco Macor, Giuseppe Mancia, Barry McGrath, Martin Middeke, Jian Ming, Stefano Omboni, Kuniaka Otsuka, Paolo Palatini, Gianfranco Parati, Carl Pieper, Poalo Verdecchia, Prince Zachariah, Weizhong Zhang

Research output: Contribution to journalReview articlepeer-review

8 Citations (Scopus)


Objective: To delineate more precisely an operational threshold for making clinical decisions based on ambulatory blood pressure (ABP) measurement by studying the ABP in subjects who were diagnosed as either normotensive or hypertensive by conventional blood pressure (CBP) measurement. Subjects: Twenty-four research groups recruited 7069 subjects. Of these, 4577 were normotensive (systolic CBP ≤ 140 mmHg and diastolic CBP ≤ 90 mmHg) and 1773 were hypertensive (systolic CBP ≥ 160 mmHg and/or diastolic CBP ≥ 90 mmHg). Of the latter, 1324 had systolic and 1310 had diastolic hypertension. Results: Ninety-five percent of the normotensive subjects had a 24-h ABP below (systolic and diastolic, respectively) 133 and 82 mmHg. Of the patients with systolic hypertension, 24% had a 24-h systolic ABP of < 133 mmHg. Similarly, 30% of those with diastolic hypertension had a 24-h diastolic ABP of < 82 mmHg. The probability that hypertensive patients had a 24-h ABP below these thresholds was higher in women than in men, increased with age and was 2- to 4-fold greater if the CBP of the patient had been measured at only one visit and if fewer than 3 CBP measurements had been averaged to establish the diagnosis of hypertension. By contrast, for each 10-mmHg increment in systolic CBP, this probability decreased by 54% for the 24-h systolic ABP and by 25% for the 24-h diastolic ABP, and for each 5 mmHg increment in diastolic CBP it increased by 6 and 9%, respectively. Conclusion: The ABP distributions of the normotensive subjects included in the present international database were not materially different from those in previous reports in the literature. One-fifth to more than one-third of the hypertensive patients had an ABP which was below the 95th centile of the ABP in normotensive subjects, but this proportion decreased if the hypertensive patients had shown a higher CBP upon repeated measurement. The prognostic implications of elevated CBP in the presence of normal ABP remain to be determined.

Original languageEnglish
Pages (from-to)106-114
Number of pages9
JournalNetherlands Journal of Medicine
Issue number2
Publication statusPublished - 1995 Feb
Externally publishedYes


  • Ambulatory blood pressure
  • Blood pressure measurement
  • Conventional blood pressure
  • Hypertension
  • Normotension

ASJC Scopus subject areas

  • Internal Medicine


Dive into the research topics of 'The ambulatory blood pressure in normotensive and hypertensive subjects: results from an international database'. Together they form a unique fingerprint.

Cite this