Double product reflects the predictive power of systolic pressure in the general population: Evidence from 9,937 Participants

Rudolph Schutte; Lutgarde Thijs; Kei Asayama; José Boggia; Yan Li; Tine W Hansen; Yan-Ping Liu; Masahiro Kikuya; Kristina Björklund-Bodegård; Takayoshi Ohkubo; Jørgen Jeppesen; Christian Torp-Pedersen; Eamon Dolan; Tatiana Kuznetsova; Katarzyna Stolarz-Skrzypek; Valérie Tikhonoff; Sofia Malyutina; Edoardo Casiglia; Yuri Nikitin; Lars  Lind; Edgardo Sandoya; Kalina Kawecka-Jaszcz; Jan Filipovsky; Yutaka Imai; Jiguang Wang; Hans Ibsen; Eoin O'Brien; Jan A Staessen; International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) Investigators

doi:10.1093/ajh/hps119

Double product reflects the predictive power of systolic pressure in the general population: Evidence from 9,937 Participants

Rudolph Schutte, Lutgarde Thijs, Kei Asayama, José Boggia, Yan Li, Tine W Hansen, Yan-Ping Liu, Masahiro Kikuya, Kristina Björklund-Bodegård, Takayoshi Ohkubo, Jørgen Jeppesen, Christian Torp-Pedersen, Eamon Dolan, Tatiana Kuznetsova, Katarzyna Stolarz-Skrzypek, Valérie Tikhonoff, Sofia Malyutina, Edoardo Casiglia, Yuri Nikitin, Lars LindEdgardo Sandoya, Kalina Kawecka-Jaszcz, Jan Filipovsky, Yutaka Imai, Jiguang Wang, Hans Ibsen, Eoin O'Brien, Jan A Staessen, International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) Investigators

Department of Clinical Medicine

25 Citations (Scopus)

Abstract

Background The double product (DP), consisting of the systolic blood pressure (SBP) multiplied by the pulse rate (PR), is an index of myocardial oxygen consumption, but its prognostic value in the general population remains unknown. Methods We recorded health outcomes in 9,937 subjects (median age, 53.2 years; 47.3% women) randomly recruited from 11 populations and enrolled in the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) study. We obtained the SBP, PR, and DP for these subjects as determined through 24-hour ambulatory monitoring. Results Over a median period of 11.0 years, 1,388 of the 9,937 study subjects died, of whom 536 and 794, respectively, died of cardiovascular (CV) and non-CV causes, and a further 1,161, 658, 494, and 465 subjects, respectively, experienced a CV, cardiac, coronary, or cerebrovascular event. In multivariate-adjusted Cox models, not including SBP and PR, DP predicted total, CV, and non-CV mortality (standardized hazard ratio [HR], ≥ 1.10; P ≤ 0.02), and all CV, cardiac, coronary, and stroke events (HR, ≥ 1.21; P < 0.0001). For CV mortality (HR, 1.34 vs. 1.30; P = 0.71) and coronary events (1.28 vs. 1.21; P = 0.26), SBP and the DP were equally predictive. As compared with DP, SBP was a stronger predictor of all CV events (1.39 vs. 1.27; P = 0.002) and stroke (1.61 vs. 1.36; P < 0.0001), and a slightly stronger predictor of cardiac events (1.32 vs. 1.22; P = 0.06). In fully adjusted models, including both SBP and PR, the predictive value of DP disappeared for fatal endpoints (P ≥ 0.07), coronary events (P = 0.06), and stroke (P = 0.12), or DP was even inversely associated with the risk of all CV and cardiac events (both P ≤ 0.01).CONCLUSIONIn the general population, we did not observe DP to add to risk stratification over and beyond SBP and PR.

Original language	English
Journal	American Journal of Hypertension
Volume	26
Issue number	5
Pages (from-to)	665-672
Number of pages	8
ISSN	0895-7061
DOIs	https://doi.org/10.1093/ajh/hps119
Publication status	Published - May 2013

Access to Document

10.1093/ajh/hps119

Cite this

Schutte, R., Thijs, L., Asayama, K., Boggia, J., Li, Y., Hansen, T. W., Liu, Y-P., 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., ... Investigators, I. D. O. A. B. P. I. R. T. C. O. (2013). Double product reflects the predictive power of systolic pressure in the general population: Evidence from 9,937 Participants. American Journal of Hypertension, 26(5), 665-672. https://doi.org/10.1093/ajh/hps119

Schutte, R, Thijs, L, Asayama, K, Boggia, J, Li, Y, Hansen, TW, Liu, Y-P, 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, Filipovsky, J, Imai, Y, Wang, J, Ibsen, H, O'Brien, E, Staessen, JA & Investigators, IDOABPIRTCO 2013, 'Double product reflects the predictive power of systolic pressure in the general population: Evidence from 9,937 Participants', American Journal of Hypertension, vol. 26, no. 5, pp. 665-672. https://doi.org/10.1093/ajh/hps119

@article{c926fc66d9da428287d59c6245c47d53,

title = "Double product reflects the predictive power of systolic pressure in the general population: Evidence from 9,937 Participants",

abstract = "Background The double product (DP), consisting of the systolic blood pressure (SBP) multiplied by the pulse rate (PR), is an index of myocardial oxygen consumption, but its prognostic value in the general population remains unknown. Methods We recorded health outcomes in 9,937 subjects (median age, 53.2 years; 47.3% women) randomly recruited from 11 populations and enrolled in the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) study. We obtained the SBP, PR, and DP for these subjects as determined through 24-hour ambulatory monitoring. Results Over a median period of 11.0 years, 1,388 of the 9,937 study subjects died, of whom 536 and 794, respectively, died of cardiovascular (CV) and non-CV causes, and a further 1,161, 658, 494, and 465 subjects, respectively, experienced a CV, cardiac, coronary, or cerebrovascular event. In multivariate-adjusted Cox models, not including SBP and PR, DP predicted total, CV, and non-CV mortality (standardized hazard ratio [HR], ≥ 1.10; P ≤ 0.02), and all CV, cardiac, coronary, and stroke events (HR, ≥ 1.21; P < 0.0001). For CV mortality (HR, 1.34 vs. 1.30; P = 0.71) and coronary events (1.28 vs. 1.21; P = 0.26), SBP and the DP were equally predictive. As compared with DP, SBP was a stronger predictor of all CV events (1.39 vs. 1.27; P = 0.002) and stroke (1.61 vs. 1.36; P < 0.0001), and a slightly stronger predictor of cardiac events (1.32 vs. 1.22; P = 0.06). In fully adjusted models, including both SBP and PR, the predictive value of DP disappeared for fatal endpoints (P ≥ 0.07), coronary events (P = 0.06), and stroke (P = 0.12), or DP was even inversely associated with the risk of all CV and cardiac events (both P ≤ 0.01).CONCLUSIONIn the general population, we did not observe DP to add to risk stratification over and beyond SBP and PR.",

author = "Rudolph Schutte and Lutgarde Thijs and Kei Asayama and Jos{\'e} Boggia and Yan Li and Hansen, {Tine W} and Yan-Ping Liu and Masahiro Kikuya and Kristina Bj{\"o}rklund-Bodeg{\aa}rd and Takayoshi Ohkubo and J{\o}rgen Jeppesen and Christian Torp-Pedersen and Eamon Dolan and Tatiana Kuznetsova and Katarzyna Stolarz-Skrzypek and Val{\'e}rie Tikhonoff and Sofia Malyutina and Edoardo Casiglia and Yuri Nikitin and Lars Lind and Edgardo Sandoya and Kalina Kawecka-Jaszcz and Jan Filipovsky and Yutaka Imai and Jiguang Wang and Hans Ibsen and Eoin O'Brien and Staessen, {Jan A} and Investigators, {International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO)}",

year = "2013",

month = may,

doi = "10.1093/ajh/hps119",

language = "English",

volume = "26",

pages = "665--672",

journal = "American Journal of Hypertension",

issn = "0895-7061",

publisher = "Oxford University Press",

number = "5",

}

TY - JOUR

T1 - Double product reflects the predictive power of systolic pressure in the general population

T2 - Evidence from 9,937 Participants

AU - Schutte, Rudolph

AU - Thijs, Lutgarde

AU - Asayama, Kei

AU - Boggia, José

AU - Li, Yan

AU - Hansen, Tine W

AU - Liu, Yan-Ping

AU - Kikuya, Masahiro

AU - Björklund-Bodegård, Kristina

AU - Ohkubo, Takayoshi

AU - Jeppesen, Jørgen

AU - Torp-Pedersen, Christian

AU - Dolan, Eamon

AU - Kuznetsova, Tatiana

AU - Stolarz-Skrzypek, Katarzyna

AU - Tikhonoff, Valérie

AU - Malyutina, Sofia

AU - Casiglia, Edoardo

AU - Nikitin, Yuri

AU - Lind, Lars

AU - Sandoya, Edgardo

AU - Kawecka-Jaszcz, Kalina

AU - Filipovsky, Jan

AU - Imai, Yutaka

AU - Wang, Jiguang

AU - Ibsen, Hans

AU - O'Brien, Eoin

AU - Staessen, Jan A

AU - Investigators, International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO)

PY - 2013/5

Y1 - 2013/5

N2 - Background The double product (DP), consisting of the systolic blood pressure (SBP) multiplied by the pulse rate (PR), is an index of myocardial oxygen consumption, but its prognostic value in the general population remains unknown. Methods We recorded health outcomes in 9,937 subjects (median age, 53.2 years; 47.3% women) randomly recruited from 11 populations and enrolled in the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) study. We obtained the SBP, PR, and DP for these subjects as determined through 24-hour ambulatory monitoring. Results Over a median period of 11.0 years, 1,388 of the 9,937 study subjects died, of whom 536 and 794, respectively, died of cardiovascular (CV) and non-CV causes, and a further 1,161, 658, 494, and 465 subjects, respectively, experienced a CV, cardiac, coronary, or cerebrovascular event. In multivariate-adjusted Cox models, not including SBP and PR, DP predicted total, CV, and non-CV mortality (standardized hazard ratio [HR], ≥ 1.10; P ≤ 0.02), and all CV, cardiac, coronary, and stroke events (HR, ≥ 1.21; P < 0.0001). For CV mortality (HR, 1.34 vs. 1.30; P = 0.71) and coronary events (1.28 vs. 1.21; P = 0.26), SBP and the DP were equally predictive. As compared with DP, SBP was a stronger predictor of all CV events (1.39 vs. 1.27; P = 0.002) and stroke (1.61 vs. 1.36; P < 0.0001), and a slightly stronger predictor of cardiac events (1.32 vs. 1.22; P = 0.06). In fully adjusted models, including both SBP and PR, the predictive value of DP disappeared for fatal endpoints (P ≥ 0.07), coronary events (P = 0.06), and stroke (P = 0.12), or DP was even inversely associated with the risk of all CV and cardiac events (both P ≤ 0.01).CONCLUSIONIn the general population, we did not observe DP to add to risk stratification over and beyond SBP and PR.

AB - Background The double product (DP), consisting of the systolic blood pressure (SBP) multiplied by the pulse rate (PR), is an index of myocardial oxygen consumption, but its prognostic value in the general population remains unknown. Methods We recorded health outcomes in 9,937 subjects (median age, 53.2 years; 47.3% women) randomly recruited from 11 populations and enrolled in the International Database on Ambulatory blood pressure in relation to Cardiovascular Outcomes (IDACO) study. We obtained the SBP, PR, and DP for these subjects as determined through 24-hour ambulatory monitoring. Results Over a median period of 11.0 years, 1,388 of the 9,937 study subjects died, of whom 536 and 794, respectively, died of cardiovascular (CV) and non-CV causes, and a further 1,161, 658, 494, and 465 subjects, respectively, experienced a CV, cardiac, coronary, or cerebrovascular event. In multivariate-adjusted Cox models, not including SBP and PR, DP predicted total, CV, and non-CV mortality (standardized hazard ratio [HR], ≥ 1.10; P ≤ 0.02), and all CV, cardiac, coronary, and stroke events (HR, ≥ 1.21; P < 0.0001). For CV mortality (HR, 1.34 vs. 1.30; P = 0.71) and coronary events (1.28 vs. 1.21; P = 0.26), SBP and the DP were equally predictive. As compared with DP, SBP was a stronger predictor of all CV events (1.39 vs. 1.27; P = 0.002) and stroke (1.61 vs. 1.36; P < 0.0001), and a slightly stronger predictor of cardiac events (1.32 vs. 1.22; P = 0.06). In fully adjusted models, including both SBP and PR, the predictive value of DP disappeared for fatal endpoints (P ≥ 0.07), coronary events (P = 0.06), and stroke (P = 0.12), or DP was even inversely associated with the risk of all CV and cardiac events (both P ≤ 0.01).CONCLUSIONIn the general population, we did not observe DP to add to risk stratification over and beyond SBP and PR.

U2 - 10.1093/ajh/hps119

DO - 10.1093/ajh/hps119

M3 - Journal article

C2 - 23391621

SN - 0895-7061

VL - 26

SP - 665

EP - 672

JO - American Journal of Hypertension

JF - American Journal of Hypertension

IS - 5

ER -

Double product reflects the predictive power of systolic pressure in the general population: Evidence from 9,937 Participants

Abstract

Access to Document

Fingerprint

Cite this