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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Home blood pressure variability as cardiovascular risk factor in the population of ohasama
Hypertension, Volume 61, No. 1, Year 2013
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Description
Blood pressure variability based on office measurement predicts outcome in selected patients. We explored whether novel indices of blood pressure variability derived from the self-measured home blood pressure predicted outcome in a general population. We monitored mortality and stroke in 2421 Ohasama residents (Iwate Prefecture, Japan). At enrollment (1988-1995), participants (mean age, 58.6 years; 60.9% women; 27.1% treated) measured their blood pressure at home, using an oscillometric device. In multivariable-adjusted Cox models, we assessed the independent predictive value of the within-subject mean systolic blood pressure (SBP) and corresponding variability as estimated by variability independent of the mean, difference between maximum and minimum blood pressure, and average real variability. Over 12.0 years (median), 412 participants died, 139 of cardiovascular causes, and 223 had a stroke. In models including morning SBP, variability independent of the mean and average real variability (median, 26 readings) predicted total and cardiovascular mortality in all of the participants (P≤0.044); variability independent of the mean predicted cardiovascular mortality in treated (P=0.014) but not in untreated (P=0.23) participants; and morning maximum and minimum blood pressure did not predict any end point (P=0.085). In models already including evening SBP, only variability independent of the mean predicted cardiovascular mortality in all and in untreated participants (P≤0.046). The R statistics, a measure for the incremental risk explained by adding blood pressure variability to models already including SBP and covariables, ranged from <0.01% to 0.88%. In a general population, new indices of blood pressure variability derived from home blood pressure did not incrementally predict outcome over and beyond mean SBP. © 2012 American Heart Association, Inc.
Authors & Co-Authors
Asayama, Kei
Belgium, Leuven
Ku Leuven
Japan, Sendai
Tohoku University
Kikuya, Masahiro
Japan, Sendai
Tohoku University
Schutte, Rudolph
Belgium, Leuven
Ku Leuven
South Africa, Potchefstroom
North-west University
Thijs, Lutgarde B.
Belgium, Leuven
Ku Leuven
Hosaka, Miki
Japan, Sendai
Tohoku University
Satoh, Michihiro
Japan, Sendai
Tohoku University
Hara, Azusa
Japan, Tokyo
National Cancer Center Japan
Obara, Taku
Japan, Sendai
Tohoku University
Inoue, Ryusuke
Japan, Sendai
Graduate School of Medicine
Metoki, Hirohito
Japan, Sendai
Tohoku University
Hirose, Takuo
France, Paris
Collège de France
Ohkubo, Takayoshi
Japan, Sendai
Tohoku University
Japan, Otsu
Shiga University of Medical Science
Staessen, Jan A.
Belgium, Leuven
Ku Leuven
Netherlands, Maastricht
Universiteit Maastricht
Imai, Yutaka
Japan, Sendai
Tohoku University
Statistics
Citations: 115
Authors: 14
Affiliations: 8
Identifiers
Doi:
10.1161/HYPERTENSIONAHA.111.00138
ISSN:
0194911X
e-ISSN:
15244563
Research Areas
Noncommunicable Diseases
Study Design
Cross Sectional Study
Participants Gender
Female