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Predicting stroke using 4 ambulatory blood pressure monitoring-derived blood pressure indices: the Ohasama Study

Ryusuke Inoue1, Takayoshi Ohkubo, Masahiro Kikuya

  • 1Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.

Hypertension (Dallas, Tex. : 1979)
|September 20, 2006
PubMed

Insights

Pulse pressure (PP) is a weaker stroke predictor than other blood pressure indices. Its predictive power increases when age is excluded from analysis, suggesting PP

Area of Science:

  • Cardiovascular epidemiology
  • Hypertension research

Background:

  • Ambulatory blood pressure monitoring (ABPM) is crucial for assessing cardiovascular risk.
  • Understanding the predictive value of different blood pressure indices for stroke is essential for public health.

Purpose of the Study:

  • To compare the predictive power of various blood pressure (BP) indices for stroke in the Japanese population.
  • To evaluate the influence of age as a covariate on the predictive accuracy of BP indices for stroke.

Main Methods:

  • Utilized ambulatory BP data from 1271 Japanese adults (aged ≥40 years).
  • Employed Cox proportional hazard regression to analyze stroke incidence over an 11-year follow-up.
  • Compared the predictive performance of systolic BP (SBP), diastolic BP (DBP), mean BP (MBP), and pulse pressure (PP).

Main Results:

  • Pulse pressure (PP) demonstrated significantly lower predictive value for stroke compared to SBP, DBP, and MBP when age was included as a covariate.
  • Excluding age from the analysis substantially increased the predictive power of PP, making it more informative than DBP and MBP.
  • Systolic BP (SBP) remained a more informative predictor than PP, even after removing age from the model.

Conclusions:

  • Pulse pressure (PP) is a less reliable predictor of stroke risk compared to other BP indices when age is considered.
  • The association between PP and stroke risk appears confounded by age, suggesting that aging itself contributes significantly to this risk.
  • Further research may refine the role of PP in stroke prediction, particularly in relation to age-adjusted models.

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