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Stronger Link With Mortality for Ambulatory Versus Clinic BP

Ambulatory BP is a stronger predictor of all-cause, cardiovascular mortality than clinic measures

WEDNESDAY, April 18, 2018 (HealthDay News) — Compared with clinic blood-pressure measurement, ambulatory blood-pressure measurement is more strongly associated with mortality, according to a study published in the April 18 issue of the New England Journal of Medicine.

José R. Banegas, M.D., from the Universidad Autónoma de Madrid, and colleagues examined clinic and 24-hour ambulatory blood-pressure data for 63,910 adults recruited from 2004 through 2014 in Spain. The correlations for blood pressure with all-cause and cardiovascular mortality were assessed for sustained hypertension, white-coat hypertension, masked hypertension, and normotension.

The researchers found that 3,808 patients died from any cause and 1,295 died from cardiovascular causes, during a median follow-up of 4.7 years. The correlation with all-cause mortality was stronger for 24-hour systolic pressure (hazard ratio, 1.58 per one-standard deviation [SD] increase in pressure, after adjustment for clinic blood pressure) than the clinic systolic pressure (hazard ratio, 1.02, after adjustment for 24-hour blood pressure). The corresponding hazard ratios were 1.55 and 1.54 per one-SD increase in pressure for nighttime ambulatory systolic pressure and for daytime ambulatory systolic pressure. These correlations persisted across subgroups. The correlation with all-cause mortality was stronger for masked hypertension than sustained hypertension or white-coat hypertension (hazard ratios, 2.83 versus 1.80 and 1.79, respectively). Similar results were seen for cardiovascular mortality.

“Ambulatory blood-pressure measurements were a stronger predictor of all-cause and cardiovascular mortality than clinic blood-pressure measurements,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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