Isolated ambulatory hypertension predicts cardiovascular morbidity in elderly men

Area of Science:

• Cardiology
• Hypertension Research
• Geriatric Medicine

Background:

• Isolated ambulatory hypertension (IAH) is defined by elevated out-of-office blood pressure (BP) with normal office BP.
• Prognostic significance of IAH for cardiovascular morbidity in elderly men is largely unknown.

Purpose of the Study:

• To investigate the prognostic significance of IAH for cardiovascular morbidity in a population of elderly men.

Main Methods:

• Evaluated 24-hour ambulatory BP, metabolic, and cardiac risk profiles in 578 untreated 70-year-old men.
• Assessed cardiovascular morbid events over 8.4 years using Cox proportional hazard regression.
• Utilized multivariate models adjusting for traditional risk factors.

Main Results:

• Both IAH and sustained hypertension were associated with increased plasma glucose, BMI, and left ventricular relative wall thickness.
• IAH (HR, 2.77) and sustained hypertension (HR, 2.94) independently predicted cardiovascular morbidity.
• Ambulatory daytime systolic BP predicted adverse outcomes independently of office BP.

Conclusions:

• IAH and sustained hypertension predict cardiovascular morbidity in elderly men.
• 24-hour ambulatory BP monitoring provides prognostic information beyond office BP readings.
• Ambulatory BP monitoring is crucial for identifying at-risk individuals considered normotensive by office BP.