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Li, Yan; Thijs, Lutgarde; Zhang, Zhen-Yu; Asayama, Kei; Hansen, Tine W.; Boggia, José; Björklund-Bodegård, Kristina; Yang, Wen-Yi; Niiranen, Teemu J.; Ntineri, Angeliki; Wei, Fang-Fei; Kikuya, Masahiro; Ohkubo, Takayoshi; Dolan, Eamon; Hozawa, Atsushi; Tsuji, Ichiro; Stolarz-Skrzypek, Katarzyna; Huang, Qi-Fang; Melgarejo, Jesus D.; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; [...]

Opposing Age-Related Trends in Absolute and Relative Risk of Adverse Health Outcomes Associated With Out-of-Office Blood Pressure

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  • Media type: E-Article
  • Title: Opposing Age-Related Trends in Absolute and Relative Risk of Adverse Health Outcomes Associated With Out-of-Office Blood Pressure
  • Contributor: Li, Yan; Thijs, Lutgarde; Zhang, Zhen-Yu; Asayama, Kei; Hansen, Tine W.; Boggia, José; Björklund-Bodegård, Kristina; Yang, Wen-Yi; Niiranen, Teemu J.; Ntineri, Angeliki; Wei, Fang-Fei; Kikuya, Masahiro; Ohkubo, Takayoshi; Dolan, Eamon; Hozawa, Atsushi; Tsuji, Ichiro; Stolarz-Skrzypek, Katarzyna; Huang, Qi-Fang; Melgarejo, Jesus D.; Tikhonoff, Valérie; Malyutina, Sofia; Casiglia, Edoardo; Nikitin, Yuri; Lind, Lars; [...]
  • Published: Ovid Technologies (Wolters Kluwer Health), 2019
  • Published in: Hypertension, 74 (2019) 6, Seite 1333-1342
  • Language: English
  • DOI: 10.1161/hypertensionaha.119.12958
  • ISSN: 0194-911X; 1524-4563
  • Origination:
  • Footnote:
  • Description: Participant-level meta-analyses assessed the age-specific relevance of office blood pressure to cardiovascular complications, but this information is lacking for out-of-office blood pressure. At baseline, daytime ambulatory (n=12 624) or home (n=5297) blood pressure were measured in 17 921 participants (51.3% women; mean age, 54.2 years) from 17 population cohorts. Subsequently, mortality and cardiovascular events were recorded. Using multivariable Cox regression, floating absolute risk was computed across 4 age bands (≤60, 61–70, 71–80, and >80 years). Over 236 491 person-years, 3855 people died and 2942 cardiovascular events occurred. From levels as low as 110/65 mm Hg, risk log-linearly increased with higher out-of-office systolic/diastolic blood pressure. From the youngest to the oldest age group, rates expressed per 1000 person-years increased ( P <0.001) from 4.4 (95% CI, 4.0–4.7) to 86.3 (76.1–96.5) for all-cause mortality and from 4.1 (3.9–4.6) to 59.8 (51.0–68.7) for cardiovascular events, whereas hazard ratios per 20-mm Hg increment in systolic out-of-office blood pressure decreased ( P ≤0.0033) from 1.42 (1.19–1.69) to 1.09 (1.05–1.12) and from 1.70 (1.51–1.92) to 1.12 (1.07–1.17), respectively. These age-related trends were similar for out-of-office diastolic pressure and were generally consistent in both sexes and across ethnicities. In conclusion, adverse outcomes were directly associated with out-of-office blood pressure in adults. At young age, the absolute risk associated with out-of-office blood pressure was low, but relative risk high, whereas with advancing age relative risk decreased and absolute risk increased. These observations highlight the need of a lifecourse approach for the management of hypertension.
  • Access State: Open Access