title: Predicting stroke using 4 ambulatory blood pressure monitoring-derived blood pressure indices: the Ohasama Study.
abstract: We investigated the association between stroke and blood pressure (BP) indices (systolic BP [SBP], diastolic BP [DBP], mean BP [MBP], and pulse pressure [PP]) determined by ambulatory BP monitoring. The predictive power for stroke of these indices was compared in the general Japanese population. We obtained ambulatory BP data in 1271 subjects (40% men) aged > or = 40 (mean: 61) years. During a mean follow-up of 11 years, 113 strokes were observed. The multivariate adjusted relative hazard and likelihood ratio for a 1-SD increase for each BP index was determined by Cox proportional hazard regression. Comparison of the likelihood ratio between Cox models including 2 indices and those including 1 index indicated that PP was significantly less informative than other indices (P<0.01 when adding MBP, SBP, or DBP to the PP model; P>0.09 when adding PP to the model including another index). However, after removing age from covariates, PP became more informative than DBP and MBP (P<0.0001 when adding PP to the MBP or DBP model, whereas SBP was more informative than PP even after removing age; P<0.05 when adding SBP to the PP model). In conclusion, PP was the weakest predictor of stroke. Exclusion of age from covariates increased the predictive power of PP, suggesting that the stroke risk associated with PP reflected the risk of aging per se.
authors.affiliation: Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Science, 1-1 Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Ryusuke
authors.initials: R
authors.lastname: Inoue
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Ohkubo
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kikuya
authors.forename: Hirohito
authors.initials: H
authors.lastname: Metoki
authors.forename: Kei
authors.initials: K
authors.lastname: Asayama
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Hoshi
authors.forename: Junichiro
authors.initials: J
authors.lastname: Hashimoto
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Totsune
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Satoh
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kondo
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Imai
mesh_terms: D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D003971:Diastole / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D005820:Genetic Testing; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D007564:Japan; D008297:Male; D011237:Predictive Value of Tests; D011674:Pulse; D020521:Stroke / Q000503:physiopathology*; D013599:Systole / Q000502:physiology