Role of ambulatory blood pressure on prediction of cardiovascular disease. A cohort study.

Autor: Vinyoles E; La Mina Primary Care Center, University of Barcelona, Barcelona, Spain. 23561evb@comb.cat.; Jordi Gol University Institute for Research in Primary Care, Barcelona, Spain. 23561evb@comb.cat.; Cardiovascular Research Group (GREC). Catalan Health Institute, Barcelona, Spain. 23561evb@comb.cat., Puig C; Jordi Gol University Institute for Research in Primary Care, Barcelona, Spain.; Cardiovascular Research Group (GREC). Catalan Health Institute, Barcelona, Spain., Roso-Llorach A; Jordi Gol University Institute for Research in Primary Care, Barcelona, Spain., Soldevila N; La Mina Primary Care Center, University of Barcelona, Barcelona, Spain.; Cardiovascular Research Group (GREC). Catalan Health Institute, Barcelona, Spain., de la Sierra A; Hypertension Unit. Mútua de Terrassa, University of Barcelona, Barcelona, Spain., Gorostidi M; Nephrology Service, Hospital Universitario Central de Asturias, Oviedo, Spain., Segura J; Hypertension Unit, Doce de Octubre Hospital, Madrid, Spain., Divison-Garrote JA; Casas Ibáñez Primary Care Center, Albacete, Spain., Muñoz MÁ; Cardiovascular Research Group (GREC). Catalan Health Institute, Barcelona, Spain., Ruilope LM; Hypertension Unit, Doce de Octubre Hospital, Madrid, Spain.
Jazyk: angličtina
Zdroj: Journal of human hypertension [J Hum Hypertens] 2023 Apr; Vol. 37 (4), pp. 279-285. Date of Electronic Publication: 2022 Mar 25.
DOI: 10.1038/s41371-022-00679-9
Abstrakt: Ambulatory blood pressure (BP) is associated with mortality, but it is also interesting to expand its association with cardiovascular morbidity. This study sought to evaluate association with cardiovascular morbidity and cardiovascular mortality. Patients without cardiovascular disease who had a first 24-hour ambulatory BP monitoring were followed-up until the onset of the first event (a combined variable of cardiovascular mortality, coronary heart disease, cerebrovascular disease, peripheral arteriopathy, or hospital admission for heart failure). Changes in antihypertensive treatment couldn't be collected. Cox regression analysis was adjusted for risk factors and office BP. We included 3907 patients (mean age, 58.0, SD 13.8 years), of whom 85.5% were hypertensive. The follow up period was 6.6 (95% CI 5.0-8.5) years. A total of 496 (12.7%) events were recorded. The incidence rate was 19.3 (95% CI 17.7-21.1) cases per 1000 person-years. The patients with an event compared to the rest of patients were mostly men, older, with higher office and ambulatory systolic BP, higher prevalence of diabetes, chronic kidney disease, dyslipidemia, and non-dipper or riser circadian profile. In the fully adjusted model, office BP loses its significant association with the main variable. Ambulatory BP association remained significant with cardiovascular morbidity and mortality, HR 1.494 (1.326-1.685) and 0.767 (0.654-0.899) for 24-hour systolic and diastolic BP, respectively. Nighttime systolic BP also maintained this significant association, 1.270 (1.016-1.587). We conclude that nighttime systolic BP and 24-hour BP are significantly associated with cardiovascular events and cardiovascular mortality in patients without cardiovascular disease attended under conditions of routine clinical practice.
(© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)
Databáze: MEDLINE
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