Invasively Measured Aortic Systolic Blood Pressure and Office Systolic Blood Pressure in Cardiovascular Risk Assessment: A Prospective Cohort Study

Esben Laugesen, Søren Tang Knudsen, Klavs Würgler Hansen, Niklas Blach Rossen, L. O. Jensen, M. G. Hansen, Henrik Munkholm, Kristian Korsgaard Thomsen, Hanne Søndergaard, Morten Bøttcher, Bent Raungaard, Morten Madsen, Adam Hulman, Daniel Witte, Hans Erik Bøtker, Per Løgstrup Poulsen

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstrakt

Aortic systolic blood pressure (BP) represents the hemodynamic cardiac and cerebral burden more directly than office systolic BP. Whether invasively measured aortic systolic BP confers additional prognostic value beyond office BP remains debated. In this study, office systolic BP and invasively measured aortic systolic BP were recorded in 21 908 patients (mean age: 63 years; 58% men; 14% with diabetes mellitus) with stable angina pectoris undergoing elective coronary angiography during January 2001 to December 2012. Multivariate Cox models were used to assess the association with incident myocardial infarction, stroke, and death. Discrimination and reclassification were assessed using Harrell's C and the Continuous Net Reclassification Index. Data were analyzed with and without stratification by diabetes mellitus status. During a median follow-up period of 3.7 years (range: 0.1-10.8 years), 422 strokes, 511 myocardial infarctions, and 1530 deaths occurred. Both office and aortic systolic BP were associated with stroke in patients with diabetes mellitus (hazard ratio per 10 mm Hg, 1.18 [95% confidence interval, 1.07-1.30] and 1.14 [95% confidence interval, 1.05-1.24], respectively) and with myocardial infarction in patients without diabetes mellitus (hazard ratio, 1.07 [95% confidence interval, 1.02-1.12] and 1.05 [95% confidence interval, 1.01-1.10], respectively). In models including both BP measurements, aortic BP lost statistical significance and aortic BP did not confer improvement in either C-statistics or net reclassification analysis. In conclusion, invasively measured aortic systolic BP does not add prognostic information about cardiovascular outcomes and all-cause mortality compared with office BP in patients with stable angina pectoris, either with or without diabetes mellitus.
OriginalsprogEngelsk
TidsskriftHypertension
Vol/bind68
Udgave nummer3
Sider (fra-til)768-774
ISSN0194-911X
DOI
StatusUdgivet - 2016

    Fingerprint

Bibliografisk note

ISI Document Delivery No.: DT1ZK Times Cited: 1 Cited Reference Count: 31 Laugesen, Esben Knudsen, Soren T. Hansen, Klavs W. Rossen, Niklas B. Jensen, Lisette Okkels Hansen, Michael G. Munkholm, Henrik Thomsen, Kristian K. Sondergaard, Hanne Bottcher, Morten Raungaard, Bent Madsen, Morten Hulman, Adam Witte, Daniel Botker, Hans Erik Poulsen, Per L. Witte, Daniel/0000-0002-0769-2922 Danish Diabetes Academy - Novo Nordisk Foundation, Denmark; Danish Diabetes Association, Denmark This work was supported by a research grant from the Danish Diabetes Academy supported by the Novo Nordisk Foundation, Denmark, and by a grant from The Danish Diabetes Association, Denmark. 1 2 Lippincott williams & wilkins Philadelphia 1524-4563

Citationsformater

Laugesen, E., Knudsen, S. T., Hansen, K. W., Rossen, N. B., Jensen, L. O., Hansen, M. G., Munkholm, H., Korsgaard Thomsen, K., Søndergaard, H., Bøttcher, M., Raungaard, B., Madsen, M., Hulman, A., Witte, D., Bøtker, H. E., & Poulsen, P. L. (2016). Invasively Measured Aortic Systolic Blood Pressure and Office Systolic Blood Pressure in Cardiovascular Risk Assessment: A Prospective Cohort Study. Hypertension, 68(3), 768-774. https://doi.org/10.1161/hypertensionaha.116.07495