Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure

Authors

Jesus D. Melgarejo, The University of Texas Rio Grande ValleyFollow
Wen-Yi Yang
Lutgarde Thijs
Kei Asayama
Tine W. Hansen
Fang-Fei Wei
Masahiro Kikuya
Takayoshi Ohkubo
Eamon Dolan
Gladys E. Maestre, The University of Texas Rio Grande ValleyFollow

Document Type

Article

Publication Date

2021

Abstract

Major adverse cardiovascular events are closely associated with 24-hour blood pressure (BP). We determined outcome-driven thresholds for 24-hour mean arterial pressure (MAP), a BP index estimated by oscillometric devices. We assessed the association of major adverse cardiovascular events with 24-hour MAP, systolic BP (SBP), and diastolic BP (DBP) in a population-based cohort (n=11 596). Statistics included multivariable Cox regression and the generalized R2 statistic to test model fit. Baseline office and 24-hour MAP averaged 97.4 and 90.4 mm Hg. Over 13.6 years (median), 2034 major adverse cardiovascular events occurred. Twenty-four-hour MAP levels of <90 >(normotension, n=6183), 90 to <92 >(elevated MAP, n=909), 92 to <96 >(stage-1 hypertension, n=1544), and ≥96 (stage-2 hypertension, n=2960) mm Hg yielded equivalent 10-year major adverse cardiovascular events risks as office MAP categorized using 2017 American thresholds for office SBP and DBP. Compared with 24-hour MAP normotension, hazard ratios were 0.96 (95% CI, 0.80–1.16), 1.32 (1.15–1.51), and 1.77 (1.59–1.97), for elevated and stage-1 and stage-2 hypertensive MAP. On top of 24-hour MAP, higher 24-hour SBP increased, whereas higher 24-hour DBP attenuated risk (P

Comments

© 2020 The Authors. Hypertension is published on behalf of the American Heart Association, Inc., by Wolters Kluwer Health, Inc.

Recommended Citation

Melgarejo Jesus D., Yang Wen-Yi, Thijs Lutgarde, Li Yan, Asayama Kei, Hansen Tine W., Wei Fang-Fei, Kikuya Masahiro, Ohkubo Takayoshi, Dolan Eamon, Stolarz-Skrzypek Katarzyna, Huang Qi-Fang, Tikhonoff Valérie, Malyutina Sofia, Casiglia Edoardo, Lind Lars, Sandoya Edgardo, Filipovský Jan, Gilis-Malinowska Natasza, … Senra H. (2021). Association of Fatal and Nonfatal Cardiovascular Outcomes With 24-Hour Mean Arterial Pressure. Hypertension, 77(1), 39–48. https://doi.org/10.1161/HYPERTENSIONAHA.120.14929

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Publication Title

Hypertension

DOI

10.1161/HYPERTENSIONAHA.120.14929

Academic Level

faculty

Mentor/PI Department

Neuroscience