Reference Values for 24-Hour Ambulatory Blood Pressure Monitoring Based on a Prognostic Criterion
Adult
Male
Blood Pressure Monitoring, Ambulatory
Middle Aged
Prognosis
3. Good health
Cohort Studies
03 medical and health sciences
0302 clinical medicine
Japan
Reference Values
Hypertension
Humans
Female
Prospective Studies
DOI:
10.1161/01.hyp.32.2.255
Publication Date:
2012-06-12T00:53:46Z
AUTHORS (7)
ABSTRACT
Abstract
—Although reference values for ambulatory blood pressure (ABP) monitoring have been investigated in several population studies, these values were derived from cross-sectional observations and were based merely on the statistical distribution of blood pressure values. Therefore, we conducted a prospective cohort study to identify reference values for 24-hour ABP in relation to prognosis. We obtained measurements of 24-hour ABP for 1542 subjects (565 men) aged 40 years and over in a general population of a rural Japanese community and then followed-up their survival status. There were 117 deaths during the follow-up period (mean, 6.2 years). The association between baseline 24-hour ABP values and mortality, examined by the Cox proportional hazards regression model adjusted for possible confounding factors, showed a better fit with a second-degree equation than with a first-degree equation. On the basis of the results of this analysis, we identified the following reference values as the optimal blood pressure ranges that predict the best prognosis: 120 to 133 mm Hg for systolic blood pressure and 65 to 78 mm Hg for diastolic blood pressure. 24-Hour ABP values >134/79 mm Hg and <119/64 mm Hg were related to increased risks for cardiovascular and noncardiovascular mortality, respectively. This is the first report to propose reference values for 24-hour ABP based on a prognostic criterion.
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