Elevated blood pressure at the first measurement predicts cardiovascular disease independently from the subsequent second reading in men, but not in women.
METHODS
There have been no investigations concerning the association of each blood pressure (BP) reading with future cardiovascular disease (CVD) when multiple measurements are taken on one occasion. This community-based, prospective cohort study (n = 23 344, mean age = 62.4 years) investigated the associations between the BP obtained from the first and second of two consecutive measurements on one occasion and future cardiovascular events in men and women.


RESULTS
During the mean follow-up of 5.5 years, 624 CVD events were identified. On the Cox regression analysis of age- and BP-adjusted models, the increased CVD risk of a hypertensive first measurement (systolic BP ≥ 140 mmHg) was independent from the second measurement in men. Even in subjects without a hypertensive second measurement, the CVD risk of the hypertensive first measurement was increased in men. In women, despite a hypertensive first measurement, subjects with a systolic BP < 130 mmHg on the second measurement showed a significantly reduced risk for CVD compared with subjects who retained a hypertensive level during the two measurements.


CONCLUSIONS
An elevated BP on the first measurement should not be disregarded for CVD risk estimation in men, even if the second BP moves to the normal range. In women, elevated BP on the first measurement may have relatively less meaning for CVD prediction if the second BP shifts to a normal range.
Division of Cardioangiology, Department of Internal Medicine .
Shinji
S
Makita
Fumitaka
F
Tanaka
Toshiyuki
T
Onoda
Masaki
M
Ohsawa
Kozo
K
Tanno
Shinichi
S
Omama
Yuki
Y
Yoshida
Yasuhiro
Y
Ishibashi
Toshie
T
Segawa
Tomohiro
T
Takahashi
Kenyu
K
Satoh
Kazuyoshi
K
Itai
Kiyomi
K
Sakata
Mutsuko
M
Ohta
Toru
T
Kuribayashi
Kuniaki
K
Ogasawara
Akira
A
Ogawa
Akira
A
Okayama
Motoyuki
M
Nakamura
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012727:Sex Characteristics
D000959:Antihypertensive Agents
Acute myocardial infarction; blood pressure; cardiovascular event; epidemiology; stroke