Opposing Age-Related Trends in Absolute and Relative Risk of Adverse Health Outcomes Associated With Out-of-Office Blood Pressure
Edgardo Sandoya; Jessica Barochiner; Wen-Yi Yang; Valérie Tikhonoff; Edoardo Casiglia; Natasza Gilis-Malinowska; Lucas Aparicio; Sofia Malyutina; Takayoshi Ohkubo; Katarzyna Stolarz-Skrzypek; Eamon Dolan; Yutaka Imai; Masahiro Kikuya; Yan Li; Lutgarde Thijs; José Boggia; Yuri Nikitin; Kristina Björklund-Bodegård; Krzysztof Narkiewicz; Qi-Fang Huang; Atsushi Hozawa; Kalina Kawecka-Jaszcz; Jesus D. Melgarejo; Jouni K. Johansson; Angeliki Ntineri; Eoin O'Brien; Gladys E. Maestre; Tine W. Hansen; Kei Asayama; Jan A. Staessen; Antti M. Jula; George Stergiou; Ichiro Tsuji; Jan Filipovský; Fang-Fei Wei; Lars Lind; Ji-Guang Wang; Teemu J. Niiranen; Zhen-Yu Zhang; Tatiana Kuznetsova
Opposing Age-Related Trends in Absolute and Relative Risk of Adverse Health Outcomes Associated With Out-of-Office Blood Pressure
Edgardo Sandoya
Jessica Barochiner
Wen-Yi Yang
Valérie Tikhonoff
Edoardo Casiglia
Natasza Gilis-Malinowska
Lucas Aparicio
Sofia Malyutina
Takayoshi Ohkubo
Katarzyna Stolarz-Skrzypek
Eamon Dolan
Yutaka Imai
Masahiro Kikuya
Yan Li
Lutgarde Thijs
José Boggia
Yuri Nikitin
Kristina Björklund-Bodegård
Krzysztof Narkiewicz
Qi-Fang Huang
Atsushi Hozawa
Kalina Kawecka-Jaszcz
Jesus D. Melgarejo
Jouni K. Johansson
Angeliki Ntineri
Eoin O'Brien
Gladys E. Maestre
Tine W. Hansen
Kei Asayama
Jan A. Staessen
Antti M. Jula
George Stergiou
Ichiro Tsuji
Jan Filipovský
Fang-Fei Wei
Lars Lind
Ji-Guang Wang
Teemu J. Niiranen
Zhen-Yu Zhang
Tatiana Kuznetsova
LIPPINCOTT WILLIAMS & WILKINS
Julkaisun pysyvä osoite on:
https://urn.fi/URN:NBN:fi-fe2021042824593
https://urn.fi/URN:NBN:fi-fe2021042824593
Tiivistelmä
Participant-level meta-analyses assessed the age-specific relevance of office blood pressure to cardiovascular complications, but this information is lacking for out-of-office blood pressure. At baseline, daytime ambulatory (n=12 624) or home (n=5297) blood pressure were measured in 17 921 participants (51.3% women; mean age, 54.2 years) from 17 population cohorts. Subsequently, mortality and cardiovascular events were recorded. Using multivariable Cox regression, floating absolute risk was computed across 4 age bands (<= 60, 61-70, 71-80, and >80 years). Over 236 491 person-years, 3855 people died and 2942 cardiovascular events occurred. From levels as low as 110/65 mm Hg, risk log-linearly increased with higher out-of-office systolic/diastolic blood pressure. From the youngest to the oldest age group, rates expressed per 1000 person-years increased (P<0.001) from 4.4 (95% CI, 4.0-4.7) to 86.3 (76.1-96.5) for all-cause mortality and from 4.1 (3.9-4.6) to 59.8 (51.0-68.7) for cardiovascular events, whereas hazard ratios per 20-mm Hg increment in systolic out-of-office blood pressure decreased (P <= 0.0033) from 1.42 (1.19-1.69) to 1.09 (1.05-1.12) and from 1.70 (1.51-1.92) to 1.12 (1.07-1.17), respectively. These age-related trends were similar for out-of-office diastolic pressure and were generally consistent in both sexes and across ethnicities. In conclusion, adverse outcomes were directly associated with out-of-office blood pressure in adults. At young age, the absolute risk associated with out-of-office blood pressure was low, but relative risk high, whereas with advancing age relative risk decreased and absolute risk increased. These observations highlight the need of a lifecourse approach for the management of hypertension.
Kokoelmat
- Rinnakkaistallenteet [19207]