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Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure

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Harvard

International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators* 2021, 'Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure', Hypertension, bind 77, nr. 1, s. 39-48. https://doi.org/10.1161/HYPERTENSIONAHA.120.14929

APA

International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators* (2021). Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure. Hypertension, 77(1), 39-48. https://doi.org/10.1161/HYPERTENSIONAHA.120.14929

CBE

International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators*. 2021. Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure. Hypertension. 77(1):39-48. https://doi.org/10.1161/HYPERTENSIONAHA.120.14929

MLA

International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators*. "Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure". Hypertension. 2021, 77(1). 39-48. https://doi.org/10.1161/HYPERTENSIONAHA.120.14929

Vancouver

International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators*. Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure. Hypertension. 2021 jan;77(1):39-48. https://doi.org/10.1161/HYPERTENSIONAHA.120.14929

Author

International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators*. / Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure. I: Hypertension. 2021 ; Bind 77, Nr. 1. s. 39-48.

Bibtex

@article{d90b4cc0e2a6470d8a66ea3ab94b7646,
title = "Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure",
abstract = "Major adverse cardiovascular events are closely associated with 24-hour blood pressure (BP). We determined outcome-driven thresholds for 24-hour mean arterial pressure (MAP), a BP index estimated by oscillometric devices. We assessed the association of major adverse cardiovascular events with 24-hour MAP, systolic BP (SBP), and diastolic BP (DBP) in a population-based cohort (n=11 596). Statistics included multivariable Cox regression and the generalized R 2statistic to test model fit. Baseline office and 24-hour MAP averaged 97.4 and 90.4 mm Hg. Over 13.6 years (median), 2034 major adverse cardiovascular events occurred. Twenty-four-hour MAP levels of <90 (normotension, n=6183), 90 to <92 (elevated MAP, n=909), 92 to <96 (stage-1 hypertension, n=1544), and ≥96 (stage-2 hypertension, n=2960) mm Hg yielded equivalent 10-year major adverse cardiovascular events risks as office MAP categorized using 2017 American thresholds for office SBP and DBP. Compared with 24-hour MAP normotension, hazard ratios were 0.96 (95% CI, 0.80-1.16), 1.32 (1.15-1.51), and 1.77 (1.59-1.97), for elevated and stage-1 and stage-2 hypertensive MAP. On top of 24-hour MAP, higher 24-hour SBP increased, whereas higher 24-hour DBP attenuated risk (P<0.001). Considering the 24-hour measurements, R 2statistics were similar for SBP (1.34) and MAP (1.28), lower for DBP than for MAP (0.47), and reduced to null, if the base model included SBP and DBP; if the ambulatory BP indexes were dichotomized according to the 2017 American guideline and the proposed 92 mm Hg for MAP, the R 2values were 0.71, 0.89, 0.32, and 0.10, respectively. In conclusion, the clinical application of 24-hour MAP thresholds in conjunction with SBP and DBP refines risk estimates. ",
keywords = "cardiovascular disease, hypertension, mean arterial pressure, mortality, oscillometry",
author = "Melgarejo, {Jesus D} and Wen-Yi Yang and Lutgarde Thijs and Yan Li and Kei Asayama and Hansen, {Tine W} and Fang-Fei Wei and Masahiro Kikuya and Takayoshi Ohkubo and Eamon Dolan and Katarzyna Stolarz-Skrzypek and Qi-Fang Huang and Val{\'e}rie Tikhonoff and Sofia Malyutina and Edoardo Casiglia and Lars Lind and Edgardo Sandoya and Jan Filipovsk{\'y} and Natasza Gilis-Malinowska and Krzysztof Narkiewicz and Kalina Kawecka-Jaszcz and Jos{\'e} Boggia and Ji-Guang Wang and Yutaka Imai and Thomas Vanassche and Peter Verhamme and Stefan Janssens and Eoin O'Brien and Maestre, {Gladys E} and Staessen, {Jan A} and Zhen-Yu Zhang and {International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome Investigators*}",
year = "2021",
month = jan,
doi = "10.1161/HYPERTENSIONAHA.120.14929",
language = "English",
volume = "77",
pages = "39--48",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams & Wilkins",
number = "1",

}

RIS

TY - JOUR

T1 - Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure

AU - Melgarejo, Jesus D

AU - Yang, Wen-Yi

AU - Thijs, Lutgarde

AU - Li, Yan

AU - Asayama, Kei

AU - Hansen, Tine W

AU - Wei, Fang-Fei

AU - Kikuya, Masahiro

AU - Ohkubo, Takayoshi

AU - Dolan, Eamon

AU - Stolarz-Skrzypek, Katarzyna

AU - Huang, Qi-Fang

AU - Tikhonoff, Valérie

AU - Malyutina, Sofia

AU - Casiglia, Edoardo

AU - Lind, Lars

AU - Sandoya, Edgardo

AU - Filipovský, Jan

AU - Gilis-Malinowska, Natasza

AU - Narkiewicz, Krzysztof

AU - Kawecka-Jaszcz, Kalina

AU - Boggia, José

AU - Wang, Ji-Guang

AU - Imai, Yutaka

AU - Vanassche, Thomas

AU - Verhamme, Peter

AU - Janssens, Stefan

AU - O'Brien, Eoin

AU - Maestre, Gladys E

AU - Staessen, Jan A

AU - Zhang, Zhen-Yu

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

PY - 2021/1

Y1 - 2021/1

N2 - Major adverse cardiovascular events are closely associated with 24-hour blood pressure (BP). We determined outcome-driven thresholds for 24-hour mean arterial pressure (MAP), a BP index estimated by oscillometric devices. We assessed the association of major adverse cardiovascular events with 24-hour MAP, systolic BP (SBP), and diastolic BP (DBP) in a population-based cohort (n=11 596). Statistics included multivariable Cox regression and the generalized R 2statistic to test model fit. Baseline office and 24-hour MAP averaged 97.4 and 90.4 mm Hg. Over 13.6 years (median), 2034 major adverse cardiovascular events occurred. Twenty-four-hour MAP levels of <90 (normotension, n=6183), 90 to <92 (elevated MAP, n=909), 92 to <96 (stage-1 hypertension, n=1544), and ≥96 (stage-2 hypertension, n=2960) mm Hg yielded equivalent 10-year major adverse cardiovascular events risks as office MAP categorized using 2017 American thresholds for office SBP and DBP. Compared with 24-hour MAP normotension, hazard ratios were 0.96 (95% CI, 0.80-1.16), 1.32 (1.15-1.51), and 1.77 (1.59-1.97), for elevated and stage-1 and stage-2 hypertensive MAP. On top of 24-hour MAP, higher 24-hour SBP increased, whereas higher 24-hour DBP attenuated risk (P<0.001). Considering the 24-hour measurements, R 2statistics were similar for SBP (1.34) and MAP (1.28), lower for DBP than for MAP (0.47), and reduced to null, if the base model included SBP and DBP; if the ambulatory BP indexes were dichotomized according to the 2017 American guideline and the proposed 92 mm Hg for MAP, the R 2values were 0.71, 0.89, 0.32, and 0.10, respectively. In conclusion, the clinical application of 24-hour MAP thresholds in conjunction with SBP and DBP refines risk estimates.

AB - Major adverse cardiovascular events are closely associated with 24-hour blood pressure (BP). We determined outcome-driven thresholds for 24-hour mean arterial pressure (MAP), a BP index estimated by oscillometric devices. We assessed the association of major adverse cardiovascular events with 24-hour MAP, systolic BP (SBP), and diastolic BP (DBP) in a population-based cohort (n=11 596). Statistics included multivariable Cox regression and the generalized R 2statistic to test model fit. Baseline office and 24-hour MAP averaged 97.4 and 90.4 mm Hg. Over 13.6 years (median), 2034 major adverse cardiovascular events occurred. Twenty-four-hour MAP levels of <90 (normotension, n=6183), 90 to <92 (elevated MAP, n=909), 92 to <96 (stage-1 hypertension, n=1544), and ≥96 (stage-2 hypertension, n=2960) mm Hg yielded equivalent 10-year major adverse cardiovascular events risks as office MAP categorized using 2017 American thresholds for office SBP and DBP. Compared with 24-hour MAP normotension, hazard ratios were 0.96 (95% CI, 0.80-1.16), 1.32 (1.15-1.51), and 1.77 (1.59-1.97), for elevated and stage-1 and stage-2 hypertensive MAP. On top of 24-hour MAP, higher 24-hour SBP increased, whereas higher 24-hour DBP attenuated risk (P<0.001). Considering the 24-hour measurements, R 2statistics were similar for SBP (1.34) and MAP (1.28), lower for DBP than for MAP (0.47), and reduced to null, if the base model included SBP and DBP; if the ambulatory BP indexes were dichotomized according to the 2017 American guideline and the proposed 92 mm Hg for MAP, the R 2values were 0.71, 0.89, 0.32, and 0.10, respectively. In conclusion, the clinical application of 24-hour MAP thresholds in conjunction with SBP and DBP refines risk estimates.

KW - cardiovascular disease

KW - hypertension

KW - mean arterial pressure

KW - mortality

KW - oscillometry

UR - http://www.scopus.com/inward/record.url?scp=85097830762&partnerID=8YFLogxK

U2 - 10.1161/HYPERTENSIONAHA.120.14929

DO - 10.1161/HYPERTENSIONAHA.120.14929

M3 - Journal article

C2 - 33296250

VL - 77

SP - 39

EP - 48

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 1

ER -

ID: 61614194