Ambulatory blood pressure monitoring and development of cardiovascular events in high-risk patients included in the Spanish ABPM registry: the CARDIORISC Event study.

Abstract:

BACKGROUND AND AIM:Ambulatory blood pressure monitoring (ABPM) is superior to conventional BP measurement in predicting outcome, with baseline 24-h, daytime and night-time absolute values, as well as relative nocturnal decline, as powerful determinants of prognosis. We aimed to evaluate ABPM estimates on the appearance of cardiovascular events and mortality in a cohort of high-risk treated hypertensive patients. METHODS AND RESULTS:A total of 2115 treated hypertensive patients with high or very high added risk were evaluated by means of office and 24-h ABPM. Cardiovascular events and mortality were assessed after a median follow-up of 4 years. Two hundred and sixty-eight patients (12.7%) experienced a primary event (nonfatal coronary or cerebrovascular event, heart failure hospitalization or cardiovascular death) and 114 died (45 from cardiovascular causes). In a multiple Cox regression model, and after adjusting for baseline cardiovascular risk and office BP, night-time SBP predicted cardiovascular events [hazard ratio for each SD increase: 1.45; 95% confidence interval (CI) 1.29-1.59]. Values above 130 mmHg increased the risk by 52% in comparison to values less than 115 mmHg. CONCLUSION:In addition to clinical determinants of cardiovascular risk and conventional BP, ABPM performed during treatment adds prognostic significance on the development of cardiovascular events in high-risk hypertensive patients. Among different ABPM-derived values, night-time SBP is the most potent predictor of outcome.

journal_name

J Hypertens

journal_title

Journal of hypertension

authors

de la Sierra A,Banegas JR,Segura J,Gorostidi M,Ruilope LM,CARDIORISC Event Investigators.

doi

10.1097/HJH.0b013e328350bb40

subject

Has Abstract

pub_date

2012-04-01 00:00:00

pages

713-9

issue

4

eissn

0263-6352

issn

1473-5598

journal_volume

30

pub_type

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