Artery Research

Volume 7, Issue 3-4, September 2013, Pages 165 - 165

3.1 OUTCOME-DRIVEN THRESHOLDS FOR AMBULATORY PULSE PRESSURE IN 9938 PEOPLE RECRUITED FROM 11 POPULATIONS

Authors
Y.-M. Gu1, T. Hansen2, K. Björklund-Bodegård3, K. Asayama1, 4, Staessen on behalf of the IDACO investigators JA1, 5
1University of Leuven, Leuven, Belgium
2Copenhagen University Hospital, Copenhagen, Denmark
3Uppsala University, Uppsala, Sweden
4Tohoku University Graduate School of Pharmaceutical Sciences, Sendai, Japan
5Maastricht University, Maastricht, Netherlands
Available Online 11 November 2013.
DOI
10.1016/j.artres.2013.10.014How to use a DOI?
Abstract

Background. Evidence-based thresholds for risk stratification based on pulse pressure (PP) are currently unavailable.

Methods. To derive outcome-driven thresholds for the 24-h ambulatory PP, we analyzed 9938 people randomly recruited from 11 populations (47.3% women). After age stratification (<60 vs. ≥60 years) and using average risk as reference, we computed multivariable-adjusted hazard ratios (HRs) to assess risk by tenths of the PP distribution or risk associated with stepwise increasing (+ 1 mm Hg) PP levels.

Results. Among 6028 younger participants (68,853 person-years), the risk of cardiovascular (HR, 1.58; P = 0.011) or cardiac (HR, 1.52; P = 0.056) events increased only in the top PP tenth (mean, 60.6 mm Hg). Using stepwise increasing PP levels, the lower boundary of the 95% confidence interval of the successive thresholds did not cross unity. Among 3910 older participants (39,923 person-years), risk increased (p≤0.028) in the top PP tenth (mean, 76.1 mm Hg). HRs were 1.30 and 1.62 for total and cardiovascular mortality, and 1.52, 1.69 for all cardiovascular, cardiac events. The lower boundary of the 95% confidence interval of the HRs associated with stepwise increasing PP levels crossed unity at 64 mm Hg. While accounting for all covariables, the top tenth of PP contributed less than 0.3% (generalized R2 statistic) to the overall risk among elderly.

Conclusions. In randomly recruited people, ambulatory PP does not add to risk stratification below age 60; in the elderly, PP is a weak risk factor with levels below 64 mm Hg probably being innocuous.

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Journal
Artery Research
Volume-Issue
7 - 3-4
Pages
165 - 165
Publication Date
2013/11/11
ISSN (Online)
1876-4401
ISSN (Print)
1872-9312
DOI
10.1016/j.artres.2013.10.014How to use a DOI?
Open Access
This is an open access article distributed under the CC BY-NC license.

Cite this article

TY  - JOUR
AU  - Y.-M. Gu
AU  - T. Hansen
AU  - K. Björklund-Bodegård
AU  - K. Asayama
AU  - Staessen on behalf of the IDACO investigators JA
PY  - 2013
DA  - 2013/11/11
TI  - 3.1 OUTCOME-DRIVEN THRESHOLDS FOR AMBULATORY PULSE PRESSURE IN 9938 PEOPLE RECRUITED FROM 11 POPULATIONS
JO  - Artery Research
SP  - 165
EP  - 165
VL  - 7
IS  - 3-4
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2013.10.014
DO  - 10.1016/j.artres.2013.10.014
ID  - Gu2013
ER  -