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Is "usual" blood pressure a proxy for 24-h ambulatory blood pressure in predicting cardiovascular outcomes?

Jerzy Gasowski1, Yan Li, Tatiana Kuznetsova

  • 1Department of Internal Medicine and Gerontology, Jagiellonian University, Kraków, Poland.

American Journal of Hypertension
|July 5, 2008
PubMed

Insights

24-hour ambulatory blood pressure (ABP) is a superior predictor of cardiovascular disease compared to conventional blood pressure (CBP) and usual blood pressure (UBP). ABP independently predicts cardiovascular outcomes, outperforming both CBP and UBP in risk assessment.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • 24-hour ambulatory blood pressure (ABP) is a stronger cardiovascular disease predictor than conventional blood pressure (CBP).
  • Comparison of ABP with usual blood pressure (UBP), corrected for regression dilution bias (RDB), is less understood.

Purpose of the Study:

  • To compare the predictive power of systolic CBP, UBP, and ABP for cardiovascular mortality and events.
  • To determine if UBP offers enhanced cardiovascular risk prediction over CBP.

Main Methods:

  • A 13-year follow-up study of 1,167 randomly selected Belgians.
  • Comparison of associations between systolic CBP, UBP, and ABP with cardiovascular mortality and events.
  • Estimation of RDB correction factor for UBP from CBP in untreated individuals.

Main Results:

  • Cardiovascular disease risk increased across quartiles of systolic CBP, UBP, and ABP.
  • Systolic ABP showed significantly stronger associations with cardiovascular mortality and events (HRs 1.38-1.33 per 10 mm Hg) compared to CBP (HRs 1.10-1.14) and UBP (HRs 1.18-1.23).
  • In Cox models, only ABP independently predicted cardiovascular outcomes when included with CBP or UBP.

Conclusions:

  • Correcting conventional blood pressure (CBP) for regression dilution bias (RDB) to estimate usual blood pressure (UBP) did not yield statistically significant associations with cardiovascular outcomes.
  • 24-hour ambulatory blood pressure (ABP) demonstrated superior predictive ability for cardiovascular outcomes compared to both CBP and UBP.
Abstract

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