Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations

T W Hansen; L Thijs; Y Li; J Boggia; Y Liu; K Asayama; M Kikuya; K Björklund-Bodegård; T Ohkubo; Jacob Jeppesen; C Torp-Pedersen; E Dolan; T Kuznetsova; K Stolarz-Skrzypek; V Tikhonoff; S Malyutina; E Casiglia; Y Nikitin; L Lind; E Sandoya; K Kawecka-Jaszcz; J Filipovský; Y Imai; J Wang; E O'Brien; J A Staessen

doi:10.1038/jhh.2013.145

Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations

T W Hansen, L Thijs, Y Li, J Boggia, Y Liu, K Asayama, M Kikuya, K Björklund-Bodegård, T Ohkubo, Jacob Jeppesen, C Torp-Pedersen, E Dolan, T Kuznetsova, K Stolarz-Skrzypek, V Tikhonoff, S Malyutina, E Casiglia, Y Nikitin, L Lind, E SandoyaK Kawecka-Jaszcz, J Filipovský, Y Imai, J Wang, E O'Brien, J A Staessen

1 Citation (Scopus)

Abstract

Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.0% women) randomly recruited from 10 populations, we studied the contribution of body mass index (BMI) to risk over and beyond BP, taking advantage of the superiority of ambulatory over conventional BP. Over 10.6 years (median), 1271 participants (15.0%) died and 1092 (12.9%), 637 (7.5%) and 443 (5.2%) experienced a fatal or nonfatal cardiovascular, cardiac or cerebrovascular event. Adjusted for sex and age, low BMI (<20.7 kg m -2) predicted death (hazard ratio (HR) vs average risk, 1.52; P<0.0001) and high BMI (≥30.9 kg m -2) predicted the cardiovascular end point (HR, 1.27; P=0.006). With adjustments including 24-h systolic BP, these HRs were 1.50 (P<0.001) and 0.98 (P=0.91), respectively. Across quartiles of the BMI distribution, 24-h and nighttime systolic BP predicted every end point (1.13≤standardized HR ≤1.67; 0.046 ≤P<0.0001). The interaction between systolic BP and BMI was nonsignificant (P≥0.22). Excluding smokers removed the contribution of BMI categories to the prediction of mortality. In conclusion, BMI only adds to BP in risk stratification for mortality but not for cardiovascular outcomes. Smoking probably explains the association between increased mortality and low BMI.

Original language	English
Journal	Journal of Human Hypertension
Volume	28
Issue number	9
Pages (from-to)	535-542
Number of pages	8
ISSN	0950-9240
DOIs	https://doi.org/10.1038/jhh.2013.145
Publication status	Published - Sept 2014

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Hansen, T. W., Thijs, L., Li, Y., Boggia, J., Liu, Y., Asayama, K., Kikuya, M., Björklund-Bodegård, K., Ohkubo, T., Jeppesen, J., Torp-Pedersen, C., Dolan, E., Kuznetsova, T., Stolarz-Skrzypek, K., Tikhonoff, V., Malyutina, S., Casiglia, E., Nikitin, Y., Lind, L., ... Staessen, J. A. (2014). Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations. Journal of Human Hypertension, 28(9), 535-542. https://doi.org/10.1038/jhh.2013.145

Hansen, TW, Thijs, L, Li, Y, Boggia, J, Liu, Y, Asayama, K, Kikuya, M, Björklund-Bodegård, K, Ohkubo, T, Jeppesen, J, Torp-Pedersen, C, Dolan, E, Kuznetsova, T, Stolarz-Skrzypek, K, Tikhonoff, V, Malyutina, S, Casiglia, E, Nikitin, Y, Lind, L, Sandoya, E, Kawecka-Jaszcz, K, Filipovský, J, Imai, Y, Wang, J, O'Brien, E & Staessen, JA 2014, 'Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations', Journal of Human Hypertension, vol. 28, no. 9, pp. 535-542. https://doi.org/10.1038/jhh.2013.145

@article{7f0b87debe4240399f34387b5563619e,

title = "Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations",

abstract = "Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.0% women) randomly recruited from 10 populations, we studied the contribution of body mass index (BMI) to risk over and beyond BP, taking advantage of the superiority of ambulatory over conventional BP. Over 10.6 years (median), 1271 participants (15.0%) died and 1092 (12.9%), 637 (7.5%) and 443 (5.2%) experienced a fatal or nonfatal cardiovascular, cardiac or cerebrovascular event. Adjusted for sex and age, low BMI (<20.7 kg m -2) predicted death (hazard ratio (HR) vs average risk, 1.52; P<0.0001) and high BMI (≥30.9 kg m -2) predicted the cardiovascular end point (HR, 1.27; P=0.006). With adjustments including 24-h systolic BP, these HRs were 1.50 (P<0.001) and 0.98 (P=0.91), respectively. Across quartiles of the BMI distribution, 24-h and nighttime systolic BP predicted every end point (1.13≤standardized HR ≤1.67; 0.046 ≤P<0.0001). The interaction between systolic BP and BMI was nonsignificant (P≥0.22). Excluding smokers removed the contribution of BMI categories to the prediction of mortality. In conclusion, BMI only adds to BP in risk stratification for mortality but not for cardiovascular outcomes. Smoking probably explains the association between increased mortality and low BMI.",

author = "Hansen, {T W} and L Thijs and Y Li and J Boggia and Y Liu and K Asayama and M Kikuya and K Bj{\"o}rklund-Bodeg{\aa}rd and T Ohkubo and Jacob Jeppesen and C Torp-Pedersen and E Dolan and T Kuznetsova and K Stolarz-Skrzypek and V Tikhonoff and S Malyutina and E Casiglia and Y Nikitin and L Lind and E Sandoya and K Kawecka-Jaszcz and J Filipovsk{\'y} and Y Imai and J Wang and E O'Brien and Staessen, {J A}",

year = "2014",

month = sep,

doi = "10.1038/jhh.2013.145",

language = "English",

volume = "28",

pages = "535--542",

journal = "Journal of Human Hypertension",

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TY - JOUR

T1 - Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations

AU - Hansen, T W

AU - Thijs, L

AU - Li, Y

AU - Boggia, J

AU - Liu, Y

AU - Asayama, K

AU - Kikuya, M

AU - Björklund-Bodegård, K

AU - Ohkubo, T

AU - Jeppesen, Jacob

AU - Torp-Pedersen, C

AU - Dolan, E

AU - Kuznetsova, T

AU - Stolarz-Skrzypek, K

AU - Tikhonoff, V

AU - Malyutina, S

AU - Casiglia, E

AU - Nikitin, Y

AU - Lind, L

AU - Sandoya, E

AU - Kawecka-Jaszcz, K

AU - Filipovský, J

AU - Imai, Y

AU - Wang, J

AU - O'Brien, E

AU - Staessen, J A

PY - 2014/9

Y1 - 2014/9

N2 - Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.0% women) randomly recruited from 10 populations, we studied the contribution of body mass index (BMI) to risk over and beyond BP, taking advantage of the superiority of ambulatory over conventional BP. Over 10.6 years (median), 1271 participants (15.0%) died and 1092 (12.9%), 637 (7.5%) and 443 (5.2%) experienced a fatal or nonfatal cardiovascular, cardiac or cerebrovascular event. Adjusted for sex and age, low BMI (<20.7 kg m -2) predicted death (hazard ratio (HR) vs average risk, 1.52; P<0.0001) and high BMI (≥30.9 kg m -2) predicted the cardiovascular end point (HR, 1.27; P=0.006). With adjustments including 24-h systolic BP, these HRs were 1.50 (P<0.001) and 0.98 (P=0.91), respectively. Across quartiles of the BMI distribution, 24-h and nighttime systolic BP predicted every end point (1.13≤standardized HR ≤1.67; 0.046 ≤P<0.0001). The interaction between systolic BP and BMI was nonsignificant (P≥0.22). Excluding smokers removed the contribution of BMI categories to the prediction of mortality. In conclusion, BMI only adds to BP in risk stratification for mortality but not for cardiovascular outcomes. Smoking probably explains the association between increased mortality and low BMI.

AB - Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.0% women) randomly recruited from 10 populations, we studied the contribution of body mass index (BMI) to risk over and beyond BP, taking advantage of the superiority of ambulatory over conventional BP. Over 10.6 years (median), 1271 participants (15.0%) died and 1092 (12.9%), 637 (7.5%) and 443 (5.2%) experienced a fatal or nonfatal cardiovascular, cardiac or cerebrovascular event. Adjusted for sex and age, low BMI (<20.7 kg m -2) predicted death (hazard ratio (HR) vs average risk, 1.52; P<0.0001) and high BMI (≥30.9 kg m -2) predicted the cardiovascular end point (HR, 1.27; P=0.006). With adjustments including 24-h systolic BP, these HRs were 1.50 (P<0.001) and 0.98 (P=0.91), respectively. Across quartiles of the BMI distribution, 24-h and nighttime systolic BP predicted every end point (1.13≤standardized HR ≤1.67; 0.046 ≤P<0.0001). The interaction between systolic BP and BMI was nonsignificant (P≥0.22). Excluding smokers removed the contribution of BMI categories to the prediction of mortality. In conclusion, BMI only adds to BP in risk stratification for mortality but not for cardiovascular outcomes. Smoking probably explains the association between increased mortality and low BMI.

U2 - 10.1038/jhh.2013.145

DO - 10.1038/jhh.2013.145

M3 - Journal article

C2 - 24430701

SN - 0950-9240

VL - 28

SP - 535

EP - 542

JO - Journal of Human Hypertension

JF - Journal of Human Hypertension

IS - 9

ER -

Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations

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