Night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives
Background: Numerous studies have shown a stronger relationship between ambulatory blood pressure (ABP), particularly night ABP, and cardiovascular events/mortality than for office blood pressure (OBP). A previous clinical trial (Syst-Eur) showed that pretreatment ABP was only a better predictor of...
| Main Authors: | , , , , |
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| Format: | Journal Article |
| Published: |
2018
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| Online Access: | http://hdl.handle.net/20.500.11937/74554 |
| _version_ | 1848763307895291904 |
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| author | Wing, L. Chowdhury, E. Reid, Christopher Beilin, L. Brown, M. |
| author_facet | Wing, L. Chowdhury, E. Reid, Christopher Beilin, L. Brown, M. |
| author_sort | Wing, L. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Numerous studies have shown a stronger relationship between ambulatory blood pressure (ABP), particularly night ABP, and cardiovascular events/mortality than for office blood pressure (OBP). A previous clinical trial (Syst-Eur) showed that pretreatment ABP was only a better predictor of outcome than OBP in placebo-treated participants. The current study in treated elderly hypertensives from the Second Australian National Blood Pressure study (ANBP2) examined whether pretreatment ABP was a better predictor of mortality than OBP over long-term (~11 years) follow-up. Participants and methods: ANBP2 was a comparative outcome trial in 6083 off-treatment or previously untreated elderly hypertensives. In the ABP substudy, at study entry, participants had ABP and nurse-performed OBP measurements. Cox proportional hazards analysis assessed the relationships between both OBP and ABP at study entry and 11-year all-cause and cardiovascular mortality, with results pooled from both active treatment phases. Results: In 702 participants, over a median of 10.8 years, including 6.7 years after the trial, 167 died (82 cardiovascular). Pretreatment 'night' systolic ABP and pulse pressure were the best predictors of '11-year' cardiovascular mortality (hazard ratios: 1.26; 95% confidence intervals: 1.10-1.45, P=0.001 and 1.18; 1.06-1.31, P=0.003, respectively) and all-cause mortality (hazard ratios: 1.15; 95% confidence intervals:1.05-1.28, P=0.005 and 1.09; 1.10-1.31, P=0.03, respectively). OBP was not a significant predictor of mortality. Conclusion: In actively treated elderly hypertensives participating in ANBP2, all-cause or cardiovascular deaths were significantly related to pretreatment ABP, particularly to night-time systolic ABP and pulse pressure, but not to OBP. |
| first_indexed | 2025-11-14T11:01:23Z |
| format | Journal Article |
| id | curtin-20.500.11937-74554 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T11:01:23Z |
| publishDate | 2018 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-745542019-07-16T03:31:01Z Night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives Wing, L. Chowdhury, E. Reid, Christopher Beilin, L. Brown, M. Background: Numerous studies have shown a stronger relationship between ambulatory blood pressure (ABP), particularly night ABP, and cardiovascular events/mortality than for office blood pressure (OBP). A previous clinical trial (Syst-Eur) showed that pretreatment ABP was only a better predictor of outcome than OBP in placebo-treated participants. The current study in treated elderly hypertensives from the Second Australian National Blood Pressure study (ANBP2) examined whether pretreatment ABP was a better predictor of mortality than OBP over long-term (~11 years) follow-up. Participants and methods: ANBP2 was a comparative outcome trial in 6083 off-treatment or previously untreated elderly hypertensives. In the ABP substudy, at study entry, participants had ABP and nurse-performed OBP measurements. Cox proportional hazards analysis assessed the relationships between both OBP and ABP at study entry and 11-year all-cause and cardiovascular mortality, with results pooled from both active treatment phases. Results: In 702 participants, over a median of 10.8 years, including 6.7 years after the trial, 167 died (82 cardiovascular). Pretreatment 'night' systolic ABP and pulse pressure were the best predictors of '11-year' cardiovascular mortality (hazard ratios: 1.26; 95% confidence intervals: 1.10-1.45, P=0.001 and 1.18; 1.06-1.31, P=0.003, respectively) and all-cause mortality (hazard ratios: 1.15; 95% confidence intervals:1.05-1.28, P=0.005 and 1.09; 1.10-1.31, P=0.03, respectively). OBP was not a significant predictor of mortality. Conclusion: In actively treated elderly hypertensives participating in ANBP2, all-cause or cardiovascular deaths were significantly related to pretreatment ABP, particularly to night-time systolic ABP and pulse pressure, but not to OBP. 2018 Journal Article http://hdl.handle.net/20.500.11937/74554 10.1097/MBP.0000000000000331 restricted |
| spellingShingle | Wing, L. Chowdhury, E. Reid, Christopher Beilin, L. Brown, M. Night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives |
| title | Night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives |
| title_full | Night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives |
| title_fullStr | Night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives |
| title_full_unstemmed | Night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives |
| title_short | Night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives |
| title_sort | night-time ambulatory blood pressure is the best pretreatment blood pressure predictor of 11-year mortality in treated older hypertensives |
| url | http://hdl.handle.net/20.500.11937/74554 |