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  • Gavish, BenjaminYazmonit Ltd, 9 Yehoshua Ben Nun St 9314527,POB 8475, IL-9108302 Jerusalem, Israel. (author)

Predictive power of 24-h ambulatory pulse pressure and its components for mortality and cardiovascular outcomes in 11 848 participants recruited from 13 populations

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • Ovid Technologies (Wolters Kluwer Health),2022
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-487675
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-487675URI
  • https://doi.org/10.1097/HJH.0000000000003258DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Background: The role of pulse pressure (PP) 'widening' at older and younger age as a cardiovascular risk factor is still controversial. Mean PP, as determined from repeated blood pressure (BP) readings, can be expressed as a sum of two components: 'elastic PP' (elPP) and 'stiffening PP' (stPP) associated, respectively, with stiffness at the diastole and its relative change during the systole. We investigated the association of 24-h ambulatory PP, elPP, and stPP ('PP variables') with mortality and composite cardiovascular events in different age classes. Method: Longitudinal population-based cohort study of adults with baseline observations that included 24-h ambulatory BP. Age classes were age 40 or less, 40-50, 50-60, 60-70, and over 70 years. Co-primary endpoints were total mortality and composite cardiovascular events. The relative risk expressed by hazard ratio per 1SD increase for each of the PP variables was calculated from multivariable-adjusted Cox regression models. Results: The 11 848 participants from 13 cohorts (age 53 +/- 16 years, 50% men) were followed for up for 13.7 +/- 6.7 years. A total of 2946 participants died (18.1 per 1000 person-years) and 2093 experienced a fatal or nonfatal cardiovascular event (12.9 per 1000 person-years). Mean PP, elPP, and stPP were, respectively, 49.7, 43.5, and 6.2 mmHg, and elPP and stPP were uncorrelated (r = -0.07). At age 50-60 years, all PP variables displayed association with risk for almost all outcomes. From age over 60 years to age over 70 years, hazard ratios of of PP and elPP were similar and decreased gradually but differently for pulse rate lower than or higher than 70 bpm, whereas stPP lacked predictive power in most cases. For age 40 years or less, elPP showed protective power for coronary events, whereas stPP and PP predicted stroke events. Adjusted and unadjusted hazard ratio variations were similar over the entire age range. Conclusion: This study provides a new basis for associating PP components with outcome and arterial properties in different age groups and at different pulse rates for both old and young age. The similarity between adjusted and unadjusted hazard ratios supports the clinical usefulness of PP components but further studies are needed to assess the prognostic significance of the PP components, especially at the young age.

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  • Bursztyn, MichaelHebrew Univ Jerusalem, Fac Med, Jerusalem, Israel.;Hypertens Clin Hadassah Med Ctr Mt Scopus, Jerusalem, Israel.;Beilinson Med Ctr, Dept Med D, Petah Tiqwa, Israel. (author)
  • Thijs, LutgardeUniv Leuven, KU Leuven, Res Unit Hypertens & Cardiovasc Epidemiol, Dept Cardiovasc Sci, Leuven, Belgium. (author)
  • Wei, Dong-MeiUniv Leuven, KU Leuven, Res Unit Hypertens & Cardiovasc Epidemiol, Dept Cardiovasc Sci, Leuven, Belgium. (author)
  • Melgarejo, Jesus D.Univ Leuven, KU Leuven, Res Unit Hypertens & Cardiovasc Epidemiol, Dept Cardiovasc Sci, Leuven, Belgium.;Univ Zulia, Lab Neurosci, Fac Med, Maracaibo, Zulia, Venezuela. (author)
  • Zhang, Zhen-YuUniv Leuven, KU Leuven, Res Unit Hypertens & Cardiovasc Epidemiol, Dept Cardiovasc Sci, Leuven, Belgium. (author)
  • Boggia, JoseUniv Repub, Ctr Nefrol, Hosp Clin, Montevideo, Uruguay.;Univ Repub, Dept Fisiopatol, Hosp Clin, Montevideo, Uruguay. (author)
  • Hansen, Tine W.Gentofte & Res Ctr Prevent & Hlth, Steno Diabet Ctr Copenhagen, Gentofte, Capital Region, Denmark. (author)
  • Asayama, KeiUniv Leuven, KU Leuven, Res Unit Hypertens & Cardiovasc Epidemiol, Dept Cardiovasc Sci, Leuven, Belgium.;Teikyo Univ, Dept Hyg & Publ Hlth, Sch Med, Tokyo, Japan.;Tohoku Inst Management Blood Pressure, Sendai, Miyagi, Japan. (author)
  • Ohkubo, TakayoshiTeikyo Univ, Dept Hyg & Publ Hlth, Sch Med, Tokyo, Japan.;Tohoku Inst Management Blood Pressure, Sendai, Miyagi, Japan. (author)
  • Kikuya, MasahiroTeikyo Univ, Dept Hyg & Publ Hlth, Sch Med, Tokyo, Japan. (author)
  • Yang, Wen-YiShanghai Jiao Tong Univ, Shanghai Gen Hosp, Sch Med, Dept Cardiol, Shanghai, Peoples R China. (author)
  • Stolarz-Skrzypek, KatarzynaJagiellonian Univ Med Coll, Dept Cardiol Intervent Electrocardiol & Hypertens, Krakow, Poland. (author)
  • Malyutina, SofiaRussian Acad Sci, Inst Internal & Prevent Med, Inst Cytol & Genet, Internal & Prevent Med Branch,Siberian Branch, Novosibirsk, Russia. (author)
  • Casiglia, Edoardo (author)
  • Lind, LarsUppsala universitet,Institutionen för folkhälso- och vårdvetenskap(Swepub:uu)larslind (author)
  • Li, YanShanghai Res Inst Hypertens, Dept Cardiovasc Med, Shanghai Key Lab Hypertens, Shanghai, Peoples R China. (author)
  • Kawecka-Jaszcz, KalinaJagiellonian Univ Med Coll, Dept Cardiol Intervent Electrocardiol & Hypertens, Krakow, Poland. (author)
  • Filipovsky, JanCharles Univ Prague, Fac Med, Plzen, Czech Republic. (author)
  • Tikhonoff, ValerieUniv Padua, Dept Med, Padua, Italy. (author)
  • Gilis-Malinowska, NataszaMed Univ Gdansk, Dept Hypertens, Gdansk, Poland. (author)
  • Dolan, EamonAsociac Espanola Primera Socorros Mutuos, Montevideo, Uruguay. (author)
  • Sandoya, EdgardoUniv Coll Dublin, Conway Inst, Dublin, Ireland.;Stroke & Hypertens Unit, Dublin, Ireland. (author)
  • Narkiewicz, KrzysztofMed Univ Gdansk, Dept Hypertens, Gdansk, Poland. (author)
  • Wang, Ji-Guang (author)
  • Imai, YutakaTohoku Inst Management Blood Pressure, Sendai, Miyagi, Japan. (author)
  • Maestre, Gladys E.Univ Texas Rio Grande Valley, Sch Med, Dept Neurosci, Brownsville, TX USA.;Univ Texas Rio Grande Valley, Sch Med, Dept Human Genet, Brownsville, TX USA. (author)
  • O'Brien, EoinUniv Coll Dublin, Conway Inst, Dublin, Ireland. (author)
  • Staessen, Jan A.Res Inst Alliance Promot Prevent Med, Mechelen, Belgium.;Univ Leuven, Biomed Sci Grp, Leuven, Belgium. (author)
  • Yazmonit Ltd, 9 Yehoshua Ben Nun St 9314527,POB 8475, IL-9108302 Jerusalem, Israel.Hebrew Univ Jerusalem, Fac Med, Jerusalem, Israel.;Hypertens Clin Hadassah Med Ctr Mt Scopus, Jerusalem, Israel.;Beilinson Med Ctr, Dept Med D, Petah Tiqwa, Israel. (creator_code:org_t)

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  • In:Journal of Hypertension: Ovid Technologies (Wolters Kluwer Health)40:11, s. 2245-22550263-63521473-5598

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