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Data from the Dublin outcome study

Eamon Dolan1, Jan A Staessen, Eoin O'Brien

  • 1Cambridge University Hospitals NHS Foundation Trust, Addenbrookes Hospital, Cambridge, UK.

Blood Pressure Monitoring
|February 16, 2008
PubMed

Insights

Ambulatory blood pressure monitoring (ABPM) better predicts cardiovascular events than clinic measurements. A novel index, ambulatory arterial stiffness index (AASI), derived from ABPM, also proves valuable for prognosis.

Area of Science:

  • Cardiovascular Medicine
  • Hypertension Research
  • Clinical Epidemiology

Background:

  • Ambulatory blood pressure monitoring (ABPM) offers superior cardiovascular event prediction compared to clinic blood pressure measurement (CBPM).
  • Cardiovascular risk management relies on accurate prognostic indicators.
  • The Dublin Outcome Study aimed to assess predictive values of ABPM indices.

Purpose of the Study:

  • To evaluate established and novel ABPM indices for cardiovascular risk prediction.
  • To determine the prognostic value of ABPM in a large patient cohort.
  • To compare ABPM-derived indices against traditional cardiovascular risk factors.

Main Methods:

  • 11,291 untreated patients underwent ABPM at baseline.
  • Ambulatory arterial stiffness index (AASI) calculated as 1 minus the regression slope of diastolic vs. systolic BP.
  • Cox proportional-hazards models used for survival analysis over a median 5.3-year follow-up.

Main Results:

  • 566 cardiovascular deaths occurred during follow-up.
  • An abnormal AASI was associated with a 2.05-fold increased risk of cardiovascular death (unadjusted).
  • Adjusted hazard ratio for abnormal AASI was 1.59, indicating independent prognostic value.

Conclusions:

  • ABPM is a superior method for predicting cardiovascular mortality over CBPM.
  • AASI, a simple index derived from ABPM, is a novel and significant prognostic tool.
  • AASI enhances cardiovascular risk stratification and patient management.
Abstract

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