Document Detail

Central versus ambulatory blood pressure in the prediction of all-cause and cardiovascular mortalities.
MedLine Citation:
PMID:  21252703     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Central systolic (SBP-C) and/or pulse pressure (PP-C) better predicts cardiovascular events than does peripheral blood pressure. The present study compared the prognostic significance of office central blood pressure with multiple measurements of out-of-office ambulatory peripheral blood pressure, with reference to office peripheral systolic (SBP-B) or pulse pressure (PP-B).
METHODS: In a community-based population of 1014 healthy participants, SBP-C and PP-C were estimated using carotid tonometry, and 24-h systolic (SBP-24 h) and pulse pressure (PP-24 h) were obtained from 24-h ambulatory blood pressure monitoring. Associations of SBP-B, PP-B, SBP-C, PP-C, SBP-24 h, and PP-24 h with all-cause and cardiovascular mortalities over a median follow-up of 15 years were examined by Cox regression analysis.
RESULTS: In multivariate analyses accounting for age, sex, BMI, smoking, fasting plasma glucose, and total cholesterol/high-density lipoprotein cholesterol ratio, only PP-C (hazard ratio 1.16, 95% confidence interval 1.01-1.32, per one standard deviation increment) was significantly predictive of all-cause mortality, whereas all but PP-B were significantly predictive of cardiovascular mortality. When SBP-B was simultaneously included in the models, SBP-24 h (2.01, 1.42-2.85) and SBP-C (1.71, 1.21-2.40) remained significantly predictive of cardiovascular mortality. When SBP-C was simultaneously included in the models, SBP-24 h (1.71, 1.16-2.52) remained significantly predictive of cardiovascular mortality.
CONCLUSION: Office central blood pressure is more valuable than office peripheral blood pressure in the prediction of all-cause and cardiovascular mortalities. Out-of-office ambulatory peripheral blood pressure (SBP-24 h) may be superior to central blood pressure in the prediction of cardiovascular mortality, but PP-C may better predict all-cause mortality than SBP-24 h or PP-24 h.
Chi-Ming Huang; Kang-Ling Wang; Hao-Min Cheng; Shao-Yuan Chuang; Shih-Hsien Sung; Wen-Chung Yu; Chih-Tai Ting; Edward G Lakatta; Frank Cp Yin; Pesus Chou; Chen-Huan Chen
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Intramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  29     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-14     Completed Date:  2011-06-16     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  454-9     Citation Subset:  IM    
Department of Medicine, Yuanshan Veterans Hospital, Yilan, Taiwan.
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MeSH Terms
Age Factors
Blood Pressure Determination*
Blood Pressure Monitoring, Ambulatory*
Cardiovascular Diseases / mortality*
Cause of Death
Middle Aged
Grant Support
Z01 AG000856-07/AG/NIA NIH HHS
Comment In:
J Hypertens. 2011 Mar;29(3):430-3   [PMID:  21317722 ]

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