Key result
Ambulatory and home SBP linked to ~32% greater CVD risk per SD.
Why the study?
The study was conducted to systematically review prospective cohort studies evaluating the role of 24-h ambulatory blood pressure measurement and home blood pressure measurement on cardiovascular disease risk prediction.
Do ambulatory and home blood pressure monitoring predict cardiovascular disease risk independently of office blood pressure?
Meta-Analysis
Do ambulatory and home blood pressure monitoring predict cardiovascular disease risk independently of office blood pressure?
Effect estimate: HR 1.32 (95% CI 1.19-1.45)
Both ambulatory and home blood pressure monitoring significantly predict cardiovascular disease risk independently of office blood pressure measurements.
OBJECTIVE: The aim of this work was to systematically review the level of evidence based on prospective cohort studies investigating the role of 24-h ambulatory blood pressure measurement (ABPM) and home blood pressure measurement (HBPM) on cardiovascular disease (CVD) risk prediction. METHODS: Eight studies were included in the meta-analysis. The Der Simonian and Laird's random-effects model with standard error adjustment using the Knapp-Hartung method was used. RESULTS: SBP from ABPM and HBPM was significantly and positively associated with CVD risk [ combined hazard ratio per 1-SD SBP, 95% confidence interval (95% CI): 1.32, 1.19-1.45, I2 = 35.8%, and 1.30, 95% CI: 1.11-1.49, I2 = 79.1%, respectively], after adjusting for office BP levels and other potential confounders. DBP from both ABPM and HBPM was positively associated with CVD risk ( combined hazard ratio per 1-SD DBP, 95% CI: 1.15, 1.01-1.29, I2 = 73.1% and 1.21, 1.05-1.37, I2 = 84.5%, respectively). CONCLUSION: BP either from ABPM or HBPM could predict CVD risk. As so, at least one of out-of-office BP measurements have to be taken into account during the evaluation of the hypertensive population.
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Panagiotakos et al. (2023) conducted a meta-analysis in Cardiovascular disease risk. Ambulatory and home blood pressure monitoring vs. Office blood pressure levels was evaluated on Cardiovascular disease (CVD) risk (HR 1.32, 95% CI 1.19-1.45). Systolic blood pressure from ambulatory and home monitoring was significantly associated with increased cardiovascular disease risk (HR 1.32, 95% CI 1.19-1.45 and HR 1.30, 95% CI 1.11-1.49 per 1-SD).
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