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Noninvasive 24-h ambulatory blood pressure and cardiovascular disease : a systematic review and meta-analysis

Conen, David and Bamberg, Fabian. (2008) Noninvasive 24-h ambulatory blood pressure and cardiovascular disease : a systematic review and meta-analysis. Journal of hypertension, Vol. 26, H. 7. pp. 1290-1299.

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Official URL: http://edoc.unibas.ch/dok/A6007676

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Abstract

OBJECTIVE: We systematically assessed the evidence regarding the association between noninvasive 24-h systolic blood pressure and incident cardiovascular events. METHODS: We searched PubMed, EMBASE, and the Cochrane Library through April 2007. Studies that prospectively followed at least 100 individuals for at least 1 year, and that reported at least one effect estimate of interest were included. Two independent investigators abstracted information on study design, subject characteristics, blood pressure measurements, outcome assessment, effect estimates, and adjustment for potential confounders. RESULTS: We identified 20 eligible articles based on 15 independent cohort studies. The association between 24-h systolic blood pressure and a combined cardiovascular endpoint was assessed in nine cohort studies, including 9299 participants who were followed up to 11.1 years and had 881 outcome events. The summary hazard ratio (95% confidence interval) per 10-mmHg increase of 24-h systolic blood pressure was 1.27 (1.18-1.38) (P > 0.001). Further adjustment for office blood pressure in four studies with 4975 participants and 499 outcome events provided a similar summary estimate [hazard ratio (95% confidence interval) per 10-mmHg increase of 24-systolic blood pressure 1.21 (1.10-1.33) (P > 0.001)]. Office blood pressure was usually assessed on a single occasion. We found no significant variability according to age, sex, population origin, baseline office blood pressure, follow-up time, diabetes, or study quality. There was a consistent association between 24-h systolic blood pressure and stroke, cardiovascular mortality, total mortality, and cardiac events with hazard ratio (95% confidence interval) per 10 mmHg increase of 24-h systolic blood pressure of 1.33 (1.22-1.44), 1.19 (1.13-1.26), 1.12 (1.07-1.17), and 1.17 (1.09-1.25), respectively. CONCLUSION: 24-h systolic blood pressure is a strong predictor of cardiovascular events, providing prognostic information independent of conventional office blood pressure.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Stationäre innere Medizin (Schifferli)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Ehemalige Einheiten Medizinische Fächer (Klinik) > Stationäre innere Medizin (Schifferli)
UniBasel Contributors:Conen, David
Item Type:Article, refereed
Article Subtype:Further Journal Contribution
Bibsysno:Link to catalogue
Publisher:Lippincott Williams & Wilkins
ISSN:0263-6352
Note:Publication type according to Uni Basel Research Database: Journal item
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Last Modified:23 May 2014 08:34
Deposited On:23 May 2014 08:34

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