Document Detail


Cardiovascular risk prediction based on home blood pressure measurement: the Didima study.
MedLine Citation:
PMID:  17620954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Although home blood pressure (HBP) is being used increasingly in clinical practice, the evidence on its prognostic value is still limited. This study in the general population investigated the value of HBP compared to office measurements (OBP) in predicting cardiovascular risk. SUBJECTS AND METHODS: In 1997 all adults of the Didima area in Greece were invited to participate in a cross-sectional study involving OBP (two visits) and HBP measurements (3 days). Incident cardiovascular morbidity and cause-specific mortality were assessed after 8.2 +/- 0.2 years (mean +/- SD). Average OBP and HBP were used in Cox regression analysis of fatal and non-fatal cardiovascular events with age, gender, history of cardiovascular disease, use of antihypertensive medication, smoking and diabetes as covariates. RESULTS: A total of 662 subjects were analysed (mean age at baseline 54.1 +/- 17.6 years). During follow-up 78 deaths (42 cardiovascular) and 67 cardiovascular events (fatal and non-fatal) were documented. Unadjusted hazard ratios for cardiovascular events per 1 mmHg blood pressure increase were for HBP systolic 1.034 (P < 0.001) and diastolic 1.037 (P < 0.01) and for OBP systolic 1.035 (P < 0.001) and diastolic 1.021 (P = 0.07). After adjustment for all available cardiovascular risk predictors, only diastolic OBP remained significant. The addition of HBP in the models already including OBP did not significantly improve the predictive ability. White coat but not masked hypertensives were at high risk. CONCLUSIONS: This study showed that both HBP and OBP are significant predictors of cardiovascular risk in the general population. However, no prognostic superiority of HBP compared to OBP has been demonstrated.
Authors:
George S Stergiou; Nikos M Baibas; Petros G Kalogeropoulos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  25     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-07-10     Completed Date:  2007-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1590-6     Citation Subset:  IM    
Affiliation:
Hypertension Center, Third University Department of Medicine, Sotiria Hospital, Athens, Greece. gstergi@med.uoa.gr
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Blood Pressure*
Female
Greece
Humans
Male
Middle Aged
Risk Factors

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