Risk stratification by ambulatory blood pressure monitoring across JNC classes of conventional blood pressure

Jana Brguljan-Hitij; Lutgarde Thijs; Yan Li; Tine W Hansen; Jose Boggia; Yan-Ping Liu; Kei Asayama; Fang-Fei Wei; Kristina Bjorklund-Bodegard; Yu-Mei Gu; Takayoshi Ohkubo; Jorgen Jeppesen; Christian Torp-Pedersen; Eamon Dolan; Tatiana Kuznetsova; Stolarz-Skrzypek Katarzyna; Valerie Tikhonoff; Sofia Malyutina; Edoardo Casiglia; Yuri Nikitin; Lars Lind; Edgardo Sandoya; Kalina Kawecka-Jaszcz; Jan Filipovsky; Yutaka Imai; Jiguang Wang; Eoin O'Brien; Jan A Staessen; International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators

doi:10.1093/ajh/hpu002

Risk stratification by ambulatory blood pressure monitoring across JNC classes of conventional blood pressure

Jana Brguljan-Hitij, Lutgarde Thijs, Yan Li, Tine W Hansen, Jose Boggia, Yan-Ping Liu, Kei Asayama, Fang-Fei Wei, Kristina Bjorklund-Bodegard, Yu-Mei Gu, Takayoshi Ohkubo, Jorgen Jeppesen, Christian Torp-Pedersen, Eamon Dolan, Tatiana Kuznetsova, Stolarz-Skrzypek Katarzyna, Valerie Tikhonoff, Sofia Malyutina, Edoardo Casiglia, Yuri NikitinLars Lind, Edgardo Sandoya, Kalina Kawecka-Jaszcz, Jan Filipovsky, Yutaka Imai, Jiguang Wang, Eoin O'Brien, Jan A Staessen, International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

50 Citationer (Scopus)

Abstract

BACKGROUND: Guidelines propose classification of conventional blood pressure (CBP) into normotension (<120/<80 mm Hg), prehypertension (120-139/80-89 mm Hg), and hypertension (≥140/≥90 mm Hg).

METHODS: To assess the potential differential contribution of ambulatory blood pressure (ABP) in predicting risk across CBP strata, we analyzed outcomes in 7,826 untreated people recruited from 11 populations.

RESULTS: During an 11.3-year period, 809 participants died (276 cardiovascular deaths) and 639, 383, and 225 experienced a cardiovascular, cardiac, or cerebrovascular event. Compared with normotension (n = 2,639), prehypertension (n = 3,076) carried higher risk (P ≤ 0.015) of cardiovascular (+41%) and cerebrovascular (+92%) endpoints; compared with hypertension (n = 2,111) prehypertension entailed lower risk (P ≤ 0.005) of total mortality (-14%) and cardiovascular mortality (-29%) and of cardiovascular (-34%), cardiac (-33%), or cerebrovascular (-47%) events. Multivariable-adjusted hazard ratios (HRs) for stroke associated with 24-hour and daytime diastolic ABP (+5 mm Hg) were higher (P ≤ 0.045) in normotension than in prehypertension and hypertension (1.98 vs.1.19 vs.1.28 and 1.73 vs.1.09 vs. 1.24, respectively) with similar trends (0.03 ≤ P ≤ 0.11) for systolic ABP (+10 mm Hg). However, HRs for fatal endpoints and cardiac events associated with ABP did not differ significantly (P ≥ 0.13) across CBP categories. Of normotensive and prehypertensive participants, 7.5% and 29.3% had masked hypertension (daytime ABP ≥135/≥85 mm Hg). Compared with true normotension (P ≤ 0.01), HRs for stroke were 3.02 in normotension and 2.97 in prehypertension associated with masked hypertension with no difference between the latter two conditions (P = 0.93).

CONCLUSION: ABP refines risk stratification in normotension and prehypertension mainly by enabling the diagnosis of masked hypertension.

Originalsprog	Engelsk
Tidsskrift	American Journal of Hypertension
Vol/bind	27
Udgave nummer	7
Sider (fra-til)	956-65
Antal sider	10
ISSN	0895-7061
DOI	https://doi.org/10.1093/ajh/hpu002
Status	Udgivet - jul. 2014
Udgivet eksternt	Ja

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10.1093/ajh/hpu002

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Brguljan-Hitij, J., Thijs, L., Li, Y., Hansen, T. W., Boggia, J., Liu, Y-P., Asayama, K., Wei, F-F., Bjorklund-Bodegard, K., Gu, Y-M., Ohkubo, T., Jeppesen, J., Torp-Pedersen, C., Dolan, E., Kuznetsova, T., Katarzyna, S-S., Tikhonoff, V., Malyutina, S., Casiglia, E., ... International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators (2014). Risk stratification by ambulatory blood pressure monitoring across JNC classes of conventional blood pressure. American Journal of Hypertension, 27(7), 956-65. https://doi.org/10.1093/ajh/hpu002

@article{7e4a9a0b66b744dba29dbdcb3526fb7e,

title = "Risk stratification by ambulatory blood pressure monitoring across JNC classes of conventional blood pressure",

abstract = "BACKGROUND: Guidelines propose classification of conventional blood pressure (CBP) into normotension (<120/<80 mm Hg), prehypertension (120-139/80-89 mm Hg), and hypertension (≥140/≥90 mm Hg).METHODS: To assess the potential differential contribution of ambulatory blood pressure (ABP) in predicting risk across CBP strata, we analyzed outcomes in 7,826 untreated people recruited from 11 populations.RESULTS: During an 11.3-year period, 809 participants died (276 cardiovascular deaths) and 639, 383, and 225 experienced a cardiovascular, cardiac, or cerebrovascular event. Compared with normotension (n = 2,639), prehypertension (n = 3,076) carried higher risk (P ≤ 0.015) of cardiovascular (+41%) and cerebrovascular (+92%) endpoints; compared with hypertension (n = 2,111) prehypertension entailed lower risk (P ≤ 0.005) of total mortality (-14%) and cardiovascular mortality (-29%) and of cardiovascular (-34%), cardiac (-33%), or cerebrovascular (-47%) events. Multivariable-adjusted hazard ratios (HRs) for stroke associated with 24-hour and daytime diastolic ABP (+5 mm Hg) were higher (P ≤ 0.045) in normotension than in prehypertension and hypertension (1.98 vs.1.19 vs.1.28 and 1.73 vs.1.09 vs. 1.24, respectively) with similar trends (0.03 ≤ P ≤ 0.11) for systolic ABP (+10 mm Hg). However, HRs for fatal endpoints and cardiac events associated with ABP did not differ significantly (P ≥ 0.13) across CBP categories. Of normotensive and prehypertensive participants, 7.5% and 29.3% had masked hypertension (daytime ABP ≥135/≥85 mm Hg). Compared with true normotension (P ≤ 0.01), HRs for stroke were 3.02 in normotension and 2.97 in prehypertension associated with masked hypertension with no difference between the latter two conditions (P = 0.93).CONCLUSION: ABP refines risk stratification in normotension and prehypertension mainly by enabling the diagnosis of masked hypertension.",

author = "Jana Brguljan-Hitij and Lutgarde Thijs and Yan Li and Hansen, {Tine W} and Jose Boggia and Yan-Ping Liu and Kei Asayama and Fang-Fei Wei and Kristina Bjorklund-Bodegard and Yu-Mei Gu and Takayoshi Ohkubo and Jorgen Jeppesen and Christian Torp-Pedersen and Eamon Dolan and Tatiana Kuznetsova and Stolarz-Skrzypek Katarzyna and Valerie Tikhonoff and Sofia Malyutina and Edoardo Casiglia and Yuri Nikitin and Lars Lind and Edgardo Sandoya and Kalina Kawecka-Jaszcz and Jan Filipovsky and Yutaka Imai and Jiguang Wang and Eoin O'Brien and Staessen, {Jan A} and {International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators}",

year = "2014",

month = jul,

doi = "10.1093/ajh/hpu002",

language = "English",

volume = "27",

pages = "956--65",

journal = "American Journal of Hypertension",

issn = "0895-7061",

publisher = "Oxford University Press",

number = "7",

}

Brguljan-Hitij, J, Thijs, L, Li, Y, Hansen, TW, Boggia, J, Liu, Y-P, Asayama, K, Wei, F-F, Bjorklund-Bodegard, K, Gu, Y-M, Ohkubo, T, Jeppesen, J, Torp-Pedersen, C, Dolan, E, Kuznetsova, T, Katarzyna, S-S, Tikhonoff, V, Malyutina, S, Casiglia, E, Nikitin, Y, Lind, L, Sandoya, E, Kawecka-Jaszcz, K, Filipovsky, J, Imai, Y, Wang, J, O'Brien, E, Staessen, JA & International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators 2014, 'Risk stratification by ambulatory blood pressure monitoring across JNC classes of conventional blood pressure', American Journal of Hypertension, bind 27, nr. 7, s. 956-65. https://doi.org/10.1093/ajh/hpu002

TY - JOUR

T1 - Risk stratification by ambulatory blood pressure monitoring across JNC classes of conventional blood pressure

AU - Brguljan-Hitij, Jana

AU - Thijs, Lutgarde

AU - Li, Yan

AU - Hansen, Tine W

AU - Boggia, Jose

AU - Liu, Yan-Ping

AU - Asayama, Kei

AU - Wei, Fang-Fei

AU - Bjorklund-Bodegard, Kristina

AU - Gu, Yu-Mei

AU - Ohkubo, Takayoshi

AU - Jeppesen, Jorgen

AU - Torp-Pedersen, Christian

AU - Dolan, Eamon

AU - Kuznetsova, Tatiana

AU - Katarzyna, Stolarz-Skrzypek

AU - Tikhonoff, Valerie

AU - Malyutina, Sofia

AU - Casiglia, Edoardo

AU - Nikitin, Yuri

AU - Lind, Lars

AU - Sandoya, Edgardo

AU - Kawecka-Jaszcz, Kalina

AU - Filipovsky, Jan

AU - Imai, Yutaka

AU - Wang, Jiguang

AU - O'Brien, Eoin

AU - Staessen, Jan A

AU - International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators

PY - 2014/7

Y1 - 2014/7

N2 - BACKGROUND: Guidelines propose classification of conventional blood pressure (CBP) into normotension (<120/<80 mm Hg), prehypertension (120-139/80-89 mm Hg), and hypertension (≥140/≥90 mm Hg).METHODS: To assess the potential differential contribution of ambulatory blood pressure (ABP) in predicting risk across CBP strata, we analyzed outcomes in 7,826 untreated people recruited from 11 populations.RESULTS: During an 11.3-year period, 809 participants died (276 cardiovascular deaths) and 639, 383, and 225 experienced a cardiovascular, cardiac, or cerebrovascular event. Compared with normotension (n = 2,639), prehypertension (n = 3,076) carried higher risk (P ≤ 0.015) of cardiovascular (+41%) and cerebrovascular (+92%) endpoints; compared with hypertension (n = 2,111) prehypertension entailed lower risk (P ≤ 0.005) of total mortality (-14%) and cardiovascular mortality (-29%) and of cardiovascular (-34%), cardiac (-33%), or cerebrovascular (-47%) events. Multivariable-adjusted hazard ratios (HRs) for stroke associated with 24-hour and daytime diastolic ABP (+5 mm Hg) were higher (P ≤ 0.045) in normotension than in prehypertension and hypertension (1.98 vs.1.19 vs.1.28 and 1.73 vs.1.09 vs. 1.24, respectively) with similar trends (0.03 ≤ P ≤ 0.11) for systolic ABP (+10 mm Hg). However, HRs for fatal endpoints and cardiac events associated with ABP did not differ significantly (P ≥ 0.13) across CBP categories. Of normotensive and prehypertensive participants, 7.5% and 29.3% had masked hypertension (daytime ABP ≥135/≥85 mm Hg). Compared with true normotension (P ≤ 0.01), HRs for stroke were 3.02 in normotension and 2.97 in prehypertension associated with masked hypertension with no difference between the latter two conditions (P = 0.93).CONCLUSION: ABP refines risk stratification in normotension and prehypertension mainly by enabling the diagnosis of masked hypertension.

AB - BACKGROUND: Guidelines propose classification of conventional blood pressure (CBP) into normotension (<120/<80 mm Hg), prehypertension (120-139/80-89 mm Hg), and hypertension (≥140/≥90 mm Hg).METHODS: To assess the potential differential contribution of ambulatory blood pressure (ABP) in predicting risk across CBP strata, we analyzed outcomes in 7,826 untreated people recruited from 11 populations.RESULTS: During an 11.3-year period, 809 participants died (276 cardiovascular deaths) and 639, 383, and 225 experienced a cardiovascular, cardiac, or cerebrovascular event. Compared with normotension (n = 2,639), prehypertension (n = 3,076) carried higher risk (P ≤ 0.015) of cardiovascular (+41%) and cerebrovascular (+92%) endpoints; compared with hypertension (n = 2,111) prehypertension entailed lower risk (P ≤ 0.005) of total mortality (-14%) and cardiovascular mortality (-29%) and of cardiovascular (-34%), cardiac (-33%), or cerebrovascular (-47%) events. Multivariable-adjusted hazard ratios (HRs) for stroke associated with 24-hour and daytime diastolic ABP (+5 mm Hg) were higher (P ≤ 0.045) in normotension than in prehypertension and hypertension (1.98 vs.1.19 vs.1.28 and 1.73 vs.1.09 vs. 1.24, respectively) with similar trends (0.03 ≤ P ≤ 0.11) for systolic ABP (+10 mm Hg). However, HRs for fatal endpoints and cardiac events associated with ABP did not differ significantly (P ≥ 0.13) across CBP categories. Of normotensive and prehypertensive participants, 7.5% and 29.3% had masked hypertension (daytime ABP ≥135/≥85 mm Hg). Compared with true normotension (P ≤ 0.01), HRs for stroke were 3.02 in normotension and 2.97 in prehypertension associated with masked hypertension with no difference between the latter two conditions (P = 0.93).CONCLUSION: ABP refines risk stratification in normotension and prehypertension mainly by enabling the diagnosis of masked hypertension.

U2 - 10.1093/ajh/hpu002

DO - 10.1093/ajh/hpu002

M3 - Journal article

C2 - 24572704

SN - 0895-7061

VL - 27

SP - 956

EP - 965

JO - American Journal of Hypertension

JF - American Journal of Hypertension

IS - 7

ER -

Risk stratification by ambulatory blood pressure monitoring across JNC classes of conventional blood pressure

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