Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations
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Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations. / Li, Yan; Thijs, Lutgarde; Hansen, Tine W; Kikuya, Masahiro; Boggia, José; Richart, Tom; Metoki, Hirohito; Ohkubo, Takayoshi; Torp-Pedersen, Christian; Kuznetsova, Tatiana; Stolarz-Skrzypek, Katarzyna; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Sandoya, Edgardo; Kawecka-Jaszcz, Kalina; Ibsen, Hans; Imai, Yutaka; Wang, Jiguang; Staessen, Jan A; International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Investigators; Li, Yan.
I: Hypertension, Bind 55, Nr. 4, 01.04.2010, s. 1040-8.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Prognostic value of the morning blood pressure surge in 5645 subjects from 8 populations
AU - Li, Yan
AU - Thijs, Lutgarde
AU - Hansen, Tine W
AU - Kikuya, Masahiro
AU - Boggia, José
AU - Richart, Tom
AU - Metoki, Hirohito
AU - Ohkubo, Takayoshi
AU - Torp-Pedersen, Christian
AU - Kuznetsova, Tatiana
AU - Stolarz-Skrzypek, Katarzyna
AU - Tikhonoff, Valérie
AU - Malyutina, Sofia
AU - Casiglia, Edoardo
AU - Nikitin, Yuri
AU - Sandoya, Edgardo
AU - Kawecka-Jaszcz, Kalina
AU - Ibsen, Hans
AU - Imai, Yutaka
AU - Wang, Jiguang
AU - Staessen, Jan A
AU - International Database on Ambulatory Blood Pressure Monitoring in Relation to Cardiovascular Outcomes Investigators
AU - Li, Yan
PY - 2010/4/1
Y1 - 2010/4/1
N2 - Previous studies on the prognostic significance of the morning blood pressure surge (MS) produced inconsistent results. Using the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome, we analyzed 5645 subjects (mean age: 53.0 years; 54.0% women) randomly recruited in 8 countries. The sleep-through and the preawakening MS were the differences in the morning blood pressure with the lowest nighttime blood pressure and the preawakening blood pressure, respectively. We computed multivariable-adjusted hazard ratios comparing the risk in ethnic- and sex-specific deciles of the MS relative to the average risk in the whole study population. During follow-up (median: 11.4 years), 785 deaths and 611 fatal and nonfatal cardiovascular events occurred. While accounting for covariables and the night:day ratio of systolic pressure, the hazard ratio of all-cause mortality was 1.32 (95% CI: 1.09 to 1.59; P=0.004) in the top decile of the systolic sleep-through MS (>or=37.0 mm Hg). For cardiovascular and noncardiovascular death, these hazard ratios were 1.18 (95% CI: 0.87 to 1.61; P=0.30) and 1.42 (95% CI: 1.11 to 1.80; P=0.005). For all cardiovascular, cardiac, coronary, and cerebrovascular events, the hazard ratios in the top decile of the systolic sleep-through MS were 1.30 (95% CI: 1.06 to 1.60; P=0.01), 1.52 (95% CI: 1.15 to 2.00; P=0.004), 1.45 (95% CI: 1.04 to 2.03; P=0.03), and 0.95 (95% CI: 0.68 to 1.32; P=0.74), respectively. Analysis of the preawakening systolic MS and the diastolic MS generated consistent results. In conclusion, a MS above the 90th percentile significantly and independently predicted cardiovascular outcome and might contribute to risk stratification by ambulatory blood pressure monitoring.
AB - Previous studies on the prognostic significance of the morning blood pressure surge (MS) produced inconsistent results. Using the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome, we analyzed 5645 subjects (mean age: 53.0 years; 54.0% women) randomly recruited in 8 countries. The sleep-through and the preawakening MS were the differences in the morning blood pressure with the lowest nighttime blood pressure and the preawakening blood pressure, respectively. We computed multivariable-adjusted hazard ratios comparing the risk in ethnic- and sex-specific deciles of the MS relative to the average risk in the whole study population. During follow-up (median: 11.4 years), 785 deaths and 611 fatal and nonfatal cardiovascular events occurred. While accounting for covariables and the night:day ratio of systolic pressure, the hazard ratio of all-cause mortality was 1.32 (95% CI: 1.09 to 1.59; P=0.004) in the top decile of the systolic sleep-through MS (>or=37.0 mm Hg). For cardiovascular and noncardiovascular death, these hazard ratios were 1.18 (95% CI: 0.87 to 1.61; P=0.30) and 1.42 (95% CI: 1.11 to 1.80; P=0.005). For all cardiovascular, cardiac, coronary, and cerebrovascular events, the hazard ratios in the top decile of the systolic sleep-through MS were 1.30 (95% CI: 1.06 to 1.60; P=0.01), 1.52 (95% CI: 1.15 to 2.00; P=0.004), 1.45 (95% CI: 1.04 to 2.03; P=0.03), and 0.95 (95% CI: 0.68 to 1.32; P=0.74), respectively. Analysis of the preawakening systolic MS and the diastolic MS generated consistent results. In conclusion, a MS above the 90th percentile significantly and independently predicted cardiovascular outcome and might contribute to risk stratification by ambulatory blood pressure monitoring.
U2 - http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.137273
DO - http://dx.doi.org/10.1161/HYPERTENSIONAHA.109.137273
M3 - Journal article
VL - 55
SP - 1040
EP - 1048
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 4
ER -
ID: 34115938