title: Stroke risk of blood pressure indices determined by home blood pressure measurement: the Ohasama study.
abstract: OBJECTIVE
  The purpose of this prospective cohort study was to investigate associations between stroke and blood pressure (BP) indices (systolic BP [SBP], diastolic BP [DBP], mean BP, and pulse pressure [PP]) determined by home BP measurement.
  
  
  METHODS
  Associations between stroke and BP indices were examined in a rural Japanese population. Home BP data of 2369 subjects (40% men) > or =35 years of age (mean, 59 years) without a history of stroke were obtained. Associations between stroke and each index were determined using Cox proportional hazards regression and the likelihood ratio (LR) test.
  
  
  RESULTS
  During follow-up (mean, 11.7 years), 238 strokes occurred. The LR test showed that SBP and mean BP were significantly more strongly associated with total and ischemic stroke than DBP and PP (LR chi2 > or =9.3, P<0.01 for SBP/mean BP, LR chi2 < or =3.8, P> or =0.05 for DBP/PP). SBP tended to be more strongly associated with total/ischemic stroke than mean BP (LR chi2=3.8, P=0.05 for SBP, LR chi2 < or =0.2, P>0.6 for mean BP). PP tended to be slightly more strongly associated with ischemic stroke than DBP (LR chi2=7.5, P<0.01 for DBP, LR chi(2)=9.3, P<0.01 for PP), whereas DBP was significantly more strongly associated with hemorrhagic stroke than PP (LR chi2=9.2, P<0.01 for DBP, LR chi2=2.5, P=0.01 for PP).
  
  
  CONCLUSIONS
  PP obtained from home BP measurements was weakly associated with stroke, whereas SBP showed the strongest association. Additionally, DBP and PP may be associated with different stroke types.
authors.affiliation: Department of Planning of Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, 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: Atsuhiro
authors.initials: A
authors.lastname: Kanno
authors.forename: Taku
authors.initials: T
authors.lastname: Obara
authors.forename: Takuo
authors.initials: T
authors.lastname: Hirose
authors.forename: Azusa
authors.initials: A
authors.lastname: Hara
authors.forename: Haruhisa
authors.initials: H
authors.lastname: Hoshi
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; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods / Q000639:trends*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000209:etiology* / Q000503:physiopathology*