Cited by 314Blood Pressure and Hypertension StudiesCardiovascular Health and Disease PreventionSodium Intake and Health

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Diagnostic Thresholds for Ambulatory Blood Pressure Monitoring Based on 10-Year Cardiovascular Risk

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Kikuya, Masahiro, Hansen, Tine W., Thijs, Lutgarde, Björklund-Bodegård, Kristina, Kuznetsova, Tatiana, Ohkubo, Takayoshi, Richart, Tom, Torp-Pedersen, Christian, Lind, Lars, Ibsen, Hans, Imai, Yutaka, Staessen, Jan A.·2007·Circulation

DOI 10.1161/circulationaha.106.662254

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Abstract

Background— Current diagnostic thresholds for ambulatory blood pressure (ABP) mainly rely on statistical parameters derived from reference populations. We determined an outcome-driven reference frame for ABP measurement. Methods and Results— We performed 24-hour ABP monitoring in 5682 participants (mean age 59.0 years; 43.3% women) enrolled in prospective population studies in Copenhagen, Denmark; Noorderkempen, Belgium; Ohasama, Japan; and Uppsala, Sweden. In multivariate analyses, we determined ABP thresholds, which yielded 10-year cardiovascular risks similar to those associated with optimal (120/80 mm Hg), normal (130/85 mm Hg), and high (140/90 mm Hg) blood pressure on office measurement. Over 9.7 years (median), 814 cardiovascular end points occurred, including 377 strokes and 435 cardiac events. Systolic/diastolic thresholds for optimal ABP were 116.8/74.2 mm Hg for 24 hours, 121.6/78.9 mm Hg for daytime, and 100.9/65.3 mm Hg for nighttime. Corresponding thresholds for normal ABP were 123.9/76.8, 129.9/82.6, and 110.2/68.1 mm Hg, respectively, and those for ambulatory hypertension were 131.0/79.4, 138.2/86.4, and 119.5/70.8 mm Hg. After rounding, approximate thresholds for optimal ABP amounted to 115/75 mm Hg for 24 hours, 120/80 mm Hg for daytime, and 100/65 mm Hg for nighttime. Rounded thresholds for normal ABP were 125/75, 130/85, and 110/70 mm Hg, respectively, and those for ambulatory hypertension were 130/80, 140/85, and 120/70 mm Hg. Conclusions— Population-based outcome-driven thresholds for optimal and normal ABP are lower than those currently proposed by hypertension guidelines.

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Authors: Kikuya, M., Hansen, T. W., Thijs, L., Björklund-Bodegård, K., Kuznetsova, T., Ohkubo, T., Richart, T., Torp-Pedersen, C., Lind, L., Ibsen, H., Imai, Y., & Staessen, J. A.
Affiliations: Uppsala University (SE)
From the Tohoku University Graduate School of Pharmaceutical Science and Medicine, Sendai, Japan (M.K., T.O., Y.I.); the Research Center for Prevention and Health, Copenhagen, Denmark (T.W.H.); the Studies Coordinating Centre, Division of Hypertension and Cardiovascular Rehabilitation, Department of Cardiovascular Diseases, University of Leuven, Leuven, Belgium (M.K., L.T., T.K., T.R., J.A.S.); the Section of Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala,...
ORCID: Kikuya, Masahiro
Hansen, Tine W.
Thijs, Lutgarde
Kuznetsova, Tatiana
Ohkubo, Takayoshi
Torp-Pedersen, Christian
Lind, Lars
Imai, Yutaka
Staessen, Jan A.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2007-04-24
Volume: 115
Issue: 16
Pages: 2145-2152
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.106.662254
OpenAlex: W1992145371
Cited by: 314
References: 34
Citations by year: 2026: 6 · 2025: 7 · 2024: 14 · 2023: 9 · 2022: 4 · 2021: 4 · 2020: 13 · 2019: 17 · 2018: 17 · 2017: 22 · 2016: 15 · 2015: 12 · 2014: 24 · 2013: 25 · 2012: 25
FWCI: 19.96
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Lirias (acceptedVersion, other-oa)
Funders: Hjerteforeningen
European Commission
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Keywords: ambulatory blood pressure monitoring, diagnostic thresholds, cardiovascular risk, hypertension, optimal blood pressure, normotension, ambulatory hypertension, 24-hour ambulatory blood pressure, stroke, cardiovascular events
MeSH terms: Adolescent, Adult, Aged, Aged, 80 and over, Alcohol Drinking, Antihypertensive Agents, Auscultation, Belgium, Cardiovascular Diseases, Circadian Rhythm, Coronary Disease, Denmark, Diabetes Mellitus, Female, Heart Failure, Humans, Hypertension, Japan, Male, Middle Aged, Myocardial Revascularization, Oscillometry, Predictive Value of Tests, Prospective Studies, Reference Values, Risk Factors, Smoking, Sweden, Reproducibility of Results, Cohort Studies, Confounding Factors, Epidemiologic, Body Mass Index, Proportional Hazards Models, Death, Sudden, Cardiac, Myocardial Ischemia, Blood Pressure Monitoring, Ambulatory, Sphygmomanometers, Stroke, Dyslipidemias

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Diagnostic Thresholds for Ambulatory Blood Pressure Monitoring Based on 10-Year Cardiovascular Risk

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