Central versus ambulatory blood pressure in the prediction of all-cause and cardiovascular mortalities

被引:118
作者
Huang, Chi-Ming [1 ]
Wang, Kang-Ling [3 ]
Cheng, Hao-Min [3 ]
Chuang, Shao-Yuan [4 ]
Sung, Shih-Hsien [2 ]
Yu, Wen-Chung [2 ]
Ting, Chih-Tai [5 ]
Lakatta, Edward G. [6 ]
Yin, Frank C. P. [7 ]
Chou, Pesus [8 ]
Chen, Chen-Huan [3 ,8 ,9 ]
机构
[1] Yuanshan Vet Hosp, Dept Med, Yilan, Taiwan
[2] Taipei Vet Gen Hosp, Dept Med, Taipei, Taiwan
[3] Taipei Vet Gen Hosp, Dept Med Res & Educ, Taipei, Taiwan
[4] Acad Sinica, Inst Biomed Sci, Taipei, Taiwan
[5] Taichung Vet Gen Hosp, Cardiovasc Ctr, Taichung, Taiwan
[6] NIA, Lab Cardiovasc Sci, Intramural Res Program, Baltimore, MD 21224 USA
[7] Washington Univ, Dept Biomed Engn, St Louis, MO USA
[8] Natl Yang Ming Univ, Dept Publ Hlth, Taipei 112, Taiwan
[9] Natl Yang Ming Univ, Cardiovasc Res Ctr, Taipei 112, Taiwan
基金
美国国家卫生研究院;
关键词
ambulatory blood pressure; central blood pressure; mortality; pulse pressure; target organ damage; CENTRAL PULSE PRESSURE; LEFT-VENTRICULAR MASS; MEASUREMENTS-WILL; ARTERIAL; EVENTS; HYPERTENSION; WELL;
D O I
10.1097/HJH.0b013e3283424b4d
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objectives Central systolic (SBP-C) and/or pulse pressure (PP-C) better predicts cardiovascular events than does peripheral blood pressure. The present study compared the prognostic significance of office central blood pressure with multiple measurements of out-of-office ambulatory peripheral blood pressure, with reference to office peripheral systolic (SBP-B) or pulse pressure (PP-B). Methods In a community-based population of 1014 healthy participants, SBP-C and PP-C were estimated using carotid tonometry, and 24-h systolic (SBP-24 h) and pulse pressure (PP-24 h) were obtained from 24-h ambulatory blood pressure monitoring. Associations of SBP-B, PP-B, SBP-C, PP-C, SBP-24 h, and PP-24 h with all-cause and cardiovascular mortalities over a median follow-up of 15 years were examined by Cox regression analysis. Results In multivariate analyses accounting for age, sex, BMI, smoking, fasting plasma glucose, and total cholesterol/high-density lipoprotein cholesterol ratio, only PP-C (hazard ratio 1.16, 95% confidence interval 1.01-1.32, per one standard deviation increment) was significantly predictive of all-cause mortality, whereas all but PP-B were significantly predictive of cardiovascular mortality. When SBP-B was simultaneously included in the models, SBP-24 h (2.01, 1.42-2.85) and SBP-C (1.71, 1.21-2.40) remained significantly predictive of cardiovascular mortality. When SBP-C was simultaneously included in the models, SBP-24 h (1.71, 1.16-2.52) remained significantly predictive of cardiovascular mortality. Conclusion Office central blood pressure is more valuable than office peripheral blood pressure in the prediction of all-cause and cardiovascular mortalities. Out-of-office ambulatory peripheral blood pressure (SBP-24 h) may be superior to central blood pressure in the prediction of cardiovascular mortality, but PP-C may better predict all-cause mortality than SBP-24 h or PP-24 h. J Hypertens 29:454-459 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.
引用
收藏
页码:454 / 459
页数:6
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