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Prognostic Significance of 24-Hour Ambulatory Blood Pressure and Holter Monitoring in Patients without Atrial

Sojeong Park1, Jisoo Park1, Yeonjoo Choi1

  • 1Ewha Womans University College of Medicine, Seoul, Korea.

Ewha Medical Journal
|July 24, 2025
PubMed

Insights

Nocturnal blood pressure, measured by 24-hour ambulatory blood pressure monitoring (ABPM), significantly predicts stroke risk in individuals without atrial fibrillation (AF). A nocturnal systolic blood pressure of 120 mmHg and diastolic blood pressure of 75 mmHg are advisable cut-off values.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Medicine

Background:

  • Cardiovascular events, including stroke, pose significant health risks.
  • Atrial fibrillation (AF) is a known risk factor for stroke, but prognostic markers in non-AF populations require further investigation.
  • 24-hour ambulatory blood pressure monitoring (ABPM) provides continuous blood pressure data, offering insights beyond routine measurements.

Purpose of the Study:

  • To evaluate the prognostic significance of 24-hour ABPM and Holter parameters for cardiovascular events, specifically stroke.
  • To identify predictive values of ABPM and Holter parameters in patients without a history of atrial fibrillation.

Main Methods:

  • A cohort of 318 patients without AF, who underwent both ABPM and Holter monitoring, was analyzed.
  • Logistic regression and Cox hazard models were used to assess the association between cardiovascular events and ABPM/Holter parameters.
  • Kaplan-Meier analysis determined cut-off values for significant predictors.

Main Results:

  • During follow-up, stroke, heart failure, and acute coronary syndrome incidences were recorded.
  • Increased night systolic blood pressure (BP) and night diastolic BP were significantly associated with an elevated risk of stroke.
  • Kaplan-Meier analysis identified cut-off values of 120 mmHg for night systolic BP and 75 mmHg for night diastolic BP, significantly differentiating stroke incidence.

Conclusions:

  • Nocturnal blood pressure, as assessed by 24-hour ABPM, is a significant predictor of stroke incidence in individuals without AF.
  • A mean nocturnal blood pressure of 120/75 mmHg is suggested as an advisable cut-off value for stroke risk assessment in this population.
Abstract

Keywords:
Blood pressure monitoringCardiovascular diseasesHolterStrokeambulatory

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