A1 Vertaisarvioitu alkuperäisartikkeli tieteellisessä lehdessä
Overall cardiovascular prognosis of isolated systolic hypertension, isolated diastolic hypertension and pulse pressure defined with home measurements: the Finn-home study
Tekijät: Niiranen TJ, Rissanen H, Johansson JK, Jula AM
Kustantaja: LIPPINCOTT WILLIAMS & WILKINS
Julkaisuvuosi: 2014
Journal: Journal of Hypertension
Tietokannassa oleva lehden nimi: JOURNAL OF HYPERTENSION
Lehden akronyymi: J HYPERTENS
Vuosikerta: 32
Numero: 3
Aloitussivu: 518
Lopetussivu: 524
Sivujen määrä: 7
ISSN: 0263-6352
DOI: https://doi.org/10.1097/HJH.0000000000000070
Tiivistelmä
Objective: The overall cardiovascular prognosis of isolated systolic hypertension, isolated diastolic hypertension and pulse pressure defined with home blood pressure (BP) measurements remains unclear.Methods: A prospective nationwide study was initiated in 2000-2001 on 1924 randomly selected participants aged 44-74 years. We determined home and office BP at baseline and classified the individuals into four groups according to their home BP levels: normotension, isolated diastolic hypertension, isolated systolic hypertension and systolic-diastolic hypertension. The primary endpoint was incidence of a composite cardiovascular event.Results: After a median follow-up of 11.2 years, 236 individuals had suffered a cardiovascular event. In multivariable Cox proportional hazard models, the relative hazards and 95% confidence intervals (CIs) for cardiovascular events were significantly higher in participants with isolated diastolic hypertension (relative hazard 1.95; 95% CI, 1.06-3.57; P=0.03), isolated systolic hypertension (relative hazard 2.08; 95% CI, 1.42-3.05; P<0.001) and systolic-diastolic hypertension (relative hazard 2.79; 95% CI, 2.02-3.86; P<0.001) than in participants with normotension. Home (relative hazard 1.21; 95% CI, 1.05-1.40; P=0.009 per 10mmHg increase), but not office (relative hazard 1.10; 95% CI, 1.00-1.21, P=0.06) pulse pressure, adjusted for mean arterial pressure, was an independent predictor of cardiovascular risk.Conclusion: Isolated diastolic and systolic hypertension defined with home measurements are associated with an increased cardiovascular risk. Close follow-up and possible treatment of these patients is therefore warranted. Home-measured pulse pressure is an independent predictor of cardiovascular events while office-measured pulse pressure is not, which fortifies the view that home BP provides more accurate risk prediction than office BP.
Objective: The overall cardiovascular prognosis of isolated systolic hypertension, isolated diastolic hypertension and pulse pressure defined with home blood pressure (BP) measurements remains unclear.Methods: A prospective nationwide study was initiated in 2000-2001 on 1924 randomly selected participants aged 44-74 years. We determined home and office BP at baseline and classified the individuals into four groups according to their home BP levels: normotension, isolated diastolic hypertension, isolated systolic hypertension and systolic-diastolic hypertension. The primary endpoint was incidence of a composite cardiovascular event.Results: After a median follow-up of 11.2 years, 236 individuals had suffered a cardiovascular event. In multivariable Cox proportional hazard models, the relative hazards and 95% confidence intervals (CIs) for cardiovascular events were significantly higher in participants with isolated diastolic hypertension (relative hazard 1.95; 95% CI, 1.06-3.57; P=0.03), isolated systolic hypertension (relative hazard 2.08; 95% CI, 1.42-3.05; P<0.001) and systolic-diastolic hypertension (relative hazard 2.79; 95% CI, 2.02-3.86; P<0.001) than in participants with normotension. Home (relative hazard 1.21; 95% CI, 1.05-1.40; P=0.009 per 10mmHg increase), but not office (relative hazard 1.10; 95% CI, 1.00-1.21, P=0.06) pulse pressure, adjusted for mean arterial pressure, was an independent predictor of cardiovascular risk.Conclusion: Isolated diastolic and systolic hypertension defined with home measurements are associated with an increased cardiovascular risk. Close follow-up and possible treatment of these patients is therefore warranted. Home-measured pulse pressure is an independent predictor of cardiovascular events while office-measured pulse pressure is not, which fortifies the view that home BP provides more accurate risk prediction than office BP.
Turun yliopiston Tutkimustietojärjestelmän portaali