A 10-mmHg increase in 24-hour ambulatory systolic blood pressure predicted all-cause mortality (HR 1.13; 95% CI 1.09-1.18), whereas clinic blood pressure measurement did not (HR 1.02).
Meta-Analysis (n=23,140)
Does 24-hour ambulatory blood pressure monitoring improve the prediction of all-cause and cardiovascular mortality compared to clinic blood pressure measurements?
24-hour ambulatory blood pressure monitoring is a significantly stronger predictor of both all-cause and cardiovascular mortality compared to standard clinic blood pressure measurements.
Estimación del efecto: HR 1.13 (95% CI 1.09-1.18)
Background: According to current clinical practice guidelines, ambulatory blood pres-sure measurement (ABPM) is recommended to confirm diagnoses of hypertension. It remains un-clear as to which method is superior in predicting mortality outcomes. Methods: Prospective observational studies, comparing ABPM with clinical blood pressure meas-urements (CBPM), were included with outcomes of the study being all-cause and cardiovascular mortality. Results: Nine studies with a total of 23,140 participants were included. Each 10-mmHg increase in 24-hour mean systolic blood pressure (SBP) was linked to a higher risk of all-cause mortality (HR: 1.13, 95% CI: 1.09–1.18), while clinic blood pressure measurement (CBPM) was not a sig-nificant predictor (HR: 1.02, 95% CI: 0.90–1.13). Nighttime SBP increases of 10 mmHg were associated with a higher all-cause mortality risk than daytime SBP (HR: 1.16, 95% CI: 1.11–1.21 versus HR: 1.08, 95% CI: 1.05–1.12). For cardiovascular mortality, a 10 mmHg increase in SBP yielded an HR of 1.21 (95% CI: 1.16–1.27) for 24-hour ABPM compared to 1.08 (95% CI: 1.04–1.11) for CBPM. Similarly, for a 5 mmHg increase in diastolic blood pressure (DBP), the HR was 1.14 (95% CI: 1.07–1.20) for 24-hour ABPM versus 1.04 (95% CI: 1.01–1.07) for clinical DBP, highlighting 24-hour monitoring as a stronger predictor for cardiovascular mortality. Conclusion: The findings of this study support the superiority of ABPM measurements in predict-ing both all-cause and cardiovascular mortality.
Soleimani et al. (Thu,) conducted a meta-analysis in Hypertension (n=23,140). 24-hour ambulatory blood pressure monitoring (ABPM) vs. Clinic blood pressure measurement (CBPM) was evaluated on All-cause mortality per 10-mmHg increase in systolic blood pressure (HR 1.13, 95% CI 1.09-1.18). A 10-mmHg increase in 24-hour ambulatory systolic blood pressure predicted all-cause mortality (HR 1.13; 95% CI 1.09-1.18), whereas clinic blood pressure measurement did not (HR 1.02).