Document Detail


Cardiovascular prognostic value of ambulatory blood pressure monitoring in a Portuguese hypertensive population followed up for 8.2 years.
MedLine Citation:
PMID:  20616705     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: We investigated the cardiovascular (CV) prognostic value of 24-h ambulatory blood pressure (ABP) and blood pressure (BP) during the six 4-h periods of the 24-h ABP length in a cohort of 1200 Portuguese hypertensive patients (aged 51±12 years) without earlier CV events.
METHOD: The presence of CV events were followed for 9.833 patient years and analyzed using a cox hazard model.
RESULTS: During the 15.2 (mean 8.2) years follow-up, there were 152 CV events (11% fatal) including 79 strokes and 52 coronary events. After adjustment for risk factors and office BP (OBP), a 1-standard deviation increment of 24-h, daytime and night-time systolic BP (SBP) significantly predicted any CV event with hazard ratios (HR) 1.41, 1.33 and 1.57, respectively, and stroke with HR 1.67, 1.58, 1.67, respectively (all P<0.01), but not coronary events. Prognostic significance of these SBP values and of night-time ABP persisted after adjustment for diastolic BP and daytime ABP, respectively, whereas the opposite did not occur. SBP night-time fall (%) inversely predicted total CV events after adjustment for diastolic BP night-time fall. Among all six 4-h periods of 24-h, increment of SBP during the first 4 h of night-time was the most powerful predictor of any CV event (HR 1.64) and stroke (HR 2.02) (both P<0.01) even after adjustment for daytime and 24-h BP.
CONCLUSION: In predicting CV events and stroke, ABP is superior to office BP, ABP systolic is superior to ABP diastolic, and night-time BP is superior to daytime BP particularly during the first 4 h of sleep.
Authors:
José Mesquita-Bastos; Susana Bertoquini; Jorge Polónia
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Blood pressure monitoring     Volume:  15     ISSN:  1473-5725     ISO Abbreviation:  Blood Press Monit     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-17     Completed Date:  2011-01-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9606438     Medline TA:  Blood Press Monit     Country:  England    
Other Details:
Languages:  eng     Pagination:  240-6     Citation Subset:  IM    
Affiliation:
Escola Superior de Saúde da Universidade de Aveiro, EPE, Aveiro, Portugal.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Pressure / physiology*
Blood Pressure Monitoring, Ambulatory*
Cardiovascular Diseases / etiology*
Circadian Rhythm / physiology
Female
Follow-Up Studies
Heart Rate
Humans
Hypertension / complications*,  physiopathology
Male
Middle Aged
Office Visits
Portugal
Prognosis
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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