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Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure

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@article{589c72a49e614bd2b67a333852f2a3a7,
title = "Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure",
abstract = "Markers of target-organ damage and 24-hour ambulatory blood pressure (BP) measurement improve cardiovascular risk stratification. The prevalence of target-organ damage and raised BP increases with aging. The study aim was to evaluate the impact of age and target-organ damage on the prognostic value of ambulatory BP. Markers of target-organ damage and ambulatory BP were measured in 1408 healthy people aged 41 or 51 (middle-aged group), and 61 or 71 (older group) years. The primary outcome was cardiovascular events after 16 years of follow-up, with data obtained from national registries. The prognostic value of BP was evaluated with Cox regression models, adjusted for traditional risk factors and target-organ damage, including left ventricular mass, pulse wave velocity, carotid plaques, and urine albumin/creatinine ratio. A total of 323 events were observed. In comparison with traditional risk factors, adding systolic BP and presence of target-organ damage improved risk stratification by increasing concordance index from 0.711 to 0.728 (P=0.01). In middle-aged subjects with target-organ damage, increment in pulse pressure (hazard ratio, 1.70; 95% confidence interval, 1.31-2.21; P<0.01) and increment in average real variability (hazard ratio, 1.29; 95% confidence interval, 1.05-1.59; P=0.02) were associated with a greater risk of cardiovascular disease compared with subjects without target-organ damage: hazard ratio, 1.04 (95% confidence interval, 0.74-1.46; P=0.81); P for interaction, 0.02; and hazard ratio, 0.89 (95% confidence interval, 0.69-1.14; P=0.36); P for interaction, 0.01. Target-organ damage may be a marker of individual susceptibility to the harmful effects of pulse pressure and BP variability on the cardiovascular system in middle-aged individuals.",
keywords = "Age Factors, Aged, Aging/physiology, Blood Pressure/physiology, Blood Pressure Monitoring, Ambulatory/methods, Cardiovascular Diseases/epidemiology, Denmark/epidemiology, Female, Follow-Up Studies, Humans, Hypertension/diagnosis, Male, Organs at Risk, Predictive Value of Tests, Prognosis, Risk Assessment/methods",
author = "Olesen, {Thomas B} and Stidsen, {Jacob V} and Blicher, {Marie K} and Manan Pareek and Susanne Rasmussen and Vishram-Nielsen, {Julie K K} and Olsen, {Michael H}",
note = "{\textcopyright} 2017 American Heart Association, Inc.",
year = "2017",
month = nov,
doi = "10.1161/HYPERTENSIONAHA.117.09173",
language = "English",
volume = "70",
pages = "1034--1041",
journal = "Hypertension",
issn = "0194-911X",
publisher = "Lippincott Williams & Wilkins",
number = "5",

}

RIS

TY - JOUR

T1 - Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure

AU - Olesen, Thomas B

AU - Stidsen, Jacob V

AU - Blicher, Marie K

AU - Pareek, Manan

AU - Rasmussen, Susanne

AU - Vishram-Nielsen, Julie K K

AU - Olsen, Michael H

N1 - © 2017 American Heart Association, Inc.

PY - 2017/11

Y1 - 2017/11

N2 - Markers of target-organ damage and 24-hour ambulatory blood pressure (BP) measurement improve cardiovascular risk stratification. The prevalence of target-organ damage and raised BP increases with aging. The study aim was to evaluate the impact of age and target-organ damage on the prognostic value of ambulatory BP. Markers of target-organ damage and ambulatory BP were measured in 1408 healthy people aged 41 or 51 (middle-aged group), and 61 or 71 (older group) years. The primary outcome was cardiovascular events after 16 years of follow-up, with data obtained from national registries. The prognostic value of BP was evaluated with Cox regression models, adjusted for traditional risk factors and target-organ damage, including left ventricular mass, pulse wave velocity, carotid plaques, and urine albumin/creatinine ratio. A total of 323 events were observed. In comparison with traditional risk factors, adding systolic BP and presence of target-organ damage improved risk stratification by increasing concordance index from 0.711 to 0.728 (P=0.01). In middle-aged subjects with target-organ damage, increment in pulse pressure (hazard ratio, 1.70; 95% confidence interval, 1.31-2.21; P<0.01) and increment in average real variability (hazard ratio, 1.29; 95% confidence interval, 1.05-1.59; P=0.02) were associated with a greater risk of cardiovascular disease compared with subjects without target-organ damage: hazard ratio, 1.04 (95% confidence interval, 0.74-1.46; P=0.81); P for interaction, 0.02; and hazard ratio, 0.89 (95% confidence interval, 0.69-1.14; P=0.36); P for interaction, 0.01. Target-organ damage may be a marker of individual susceptibility to the harmful effects of pulse pressure and BP variability on the cardiovascular system in middle-aged individuals.

AB - Markers of target-organ damage and 24-hour ambulatory blood pressure (BP) measurement improve cardiovascular risk stratification. The prevalence of target-organ damage and raised BP increases with aging. The study aim was to evaluate the impact of age and target-organ damage on the prognostic value of ambulatory BP. Markers of target-organ damage and ambulatory BP were measured in 1408 healthy people aged 41 or 51 (middle-aged group), and 61 or 71 (older group) years. The primary outcome was cardiovascular events after 16 years of follow-up, with data obtained from national registries. The prognostic value of BP was evaluated with Cox regression models, adjusted for traditional risk factors and target-organ damage, including left ventricular mass, pulse wave velocity, carotid plaques, and urine albumin/creatinine ratio. A total of 323 events were observed. In comparison with traditional risk factors, adding systolic BP and presence of target-organ damage improved risk stratification by increasing concordance index from 0.711 to 0.728 (P=0.01). In middle-aged subjects with target-organ damage, increment in pulse pressure (hazard ratio, 1.70; 95% confidence interval, 1.31-2.21; P<0.01) and increment in average real variability (hazard ratio, 1.29; 95% confidence interval, 1.05-1.59; P=0.02) were associated with a greater risk of cardiovascular disease compared with subjects without target-organ damage: hazard ratio, 1.04 (95% confidence interval, 0.74-1.46; P=0.81); P for interaction, 0.02; and hazard ratio, 0.89 (95% confidence interval, 0.69-1.14; P=0.36); P for interaction, 0.01. Target-organ damage may be a marker of individual susceptibility to the harmful effects of pulse pressure and BP variability on the cardiovascular system in middle-aged individuals.

KW - Age Factors

KW - Aged

KW - Aging/physiology

KW - Blood Pressure/physiology

KW - Blood Pressure Monitoring, Ambulatory/methods

KW - Cardiovascular Diseases/epidemiology

KW - Denmark/epidemiology

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Hypertension/diagnosis

KW - Male

KW - Organs at Risk

KW - Predictive Value of Tests

KW - Prognosis

KW - Risk Assessment/methods

U2 - 10.1161/HYPERTENSIONAHA.117.09173

DO - 10.1161/HYPERTENSIONAHA.117.09173

M3 - Journal article

C2 - 28893899

VL - 70

SP - 1034

EP - 1041

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 5

ER -

ID: 56934252