Sleep pulse pressure and awake mean pressure as independent predictors for stroke in older hypertensive patients
Why the study?
Are sleep pulse pressure and awake mean blood pressure independent predictors of stroke in older hypertensive patients?
Population
811 older hypertensive patients who underwent ambulatory blood pressure monitoring
Design
Cohort
Follow-up
mean 42 months
Authors
Discussion
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Member takes
Implication
May support closer ambulatory BP monitoring in older hypertensives; leaves open whether targeting sleep PP or awake MBP reduces stroke.
Key Points
- To determine whether ambulatory pulse pressure or mean blood pressure is a stronger predictor of stroke risk in older hypertensive individuals.
- Followed 811 older hypertensive patients undergoing ambulatory blood pressure monitoring for a mean duration of 42 months.
- Assessed silent cerebral infarcts via brain magnetic resonance imaging in a subset of 515 patients at baseline.
- Each 10 mm Hg increase in sleep pulse pressure was independently associated with a 43% increase in stroke risk (95% CI: 16%–75%, P = .001), whereas sleep mean blood pressure was non-significant.
- Each 10 mm Hg increase in awake mean blood pressure was associated with a 48% increase in stroke risk (95% CI: 21%–81%, P = .0002), whereas awake pulse pressure was non-significant.
- After adjusting for baseline silent cerebral infarcts, stroke risk remained significantly elevated per 10 mm Hg increase in awake mean blood pressure (38% increase, P = .007) and sleep pulse pressure (32% increase, P = .016).
Structured PICO
Are sleep pulse pressure and awake mean blood pressure independent predictors of stroke in older hypertensive patients?
P
Population
811 older hypertensive patients who underwent ambulatory blood pressure monitoring
I
Intervention
Ambulatory blood pressure monitoring (specifically assessing sleep pulse pressure and awake mean blood pressure)
O
Outcome
Stroke eventshard clinical
In older hypertensive patients, sleep pulse pressure and awake mean blood pressure are independent predictors of stroke, even after adjusting for baseline silent cerebral infarcts.
Cite This Study
Kazuomi Kario (2004) studied this question.