TY - JOUR
T1 - Ambulatory blood pressure monitoring for risk stratification in obese and non-obese subjects from 10 populations
AU - Hansen, T W
AU - Thijs, L
AU - Li, Y
AU - Boggia, J
AU - Liu, Y
AU - Asayama, K
AU - Kikuya, M
AU - Björklund-Bodegård, K
AU - Ohkubo, T
AU - Jeppesen, Jacob
AU - Torp-Pedersen, C
AU - Dolan, E
AU - Kuznetsova, T
AU - Stolarz-Skrzypek, K
AU - Tikhonoff, V
AU - Malyutina, S
AU - Casiglia, E
AU - Nikitin, Y
AU - Lind, L
AU - Sandoya, E
AU - Kawecka-Jaszcz, K
AU - Filipovský, J
AU - Imai, Y
AU - Wang, J
AU - O'Brien, E
AU - Staessen, J A
PY - 2014/9
Y1 - 2014/9
N2 - Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.0% women) randomly recruited from 10 populations, we studied the contribution of body mass index (BMI) to risk over and beyond BP, taking advantage of the superiority of ambulatory over conventional BP. Over 10.6 years (median), 1271 participants (15.0%) died and 1092 (12.9%), 637 (7.5%) and 443 (5.2%) experienced a fatal or nonfatal cardiovascular, cardiac or cerebrovascular event. Adjusted for sex and age, low BMI (<20.7 kg m(-2)) predicted death (hazard ratio (HR) vs average risk, 1.52; P<0.0001) and high BMI (> or = 30.9 kg m(-2)) predicted the cardiovascular end point (HR, 1.27; P=0.006). With adjustments including 24-h systolic BP, these HRs were 1.50 (P<0.001) and 0.98 (P=0.91), respectively. Across quartiles of the BMI distribution, 24-h and nighttime systolic BP predicted every end point (1.13 < or = standardized HR < or = 1.67; 0.046 < or = P<0.0001). The interaction between systolic BP and BMI was nonsignificant (P > or = .22). Excluding smokers removed the contribution of BMI categories to the prediction of mortality. In conclusion, BMI only adds to BP in risk stratification for mortality but not for cardiovascular outcomes. Smoking probably explains the association between increased mortality and low BMI.
AB - Overweight clusters with high blood pressure (BP), but the independent contribution of both risk factors remains insufficiently documented. In a prospective population study involving 8467 participants (mean age 54.6 years; 47.0% women) randomly recruited from 10 populations, we studied the contribution of body mass index (BMI) to risk over and beyond BP, taking advantage of the superiority of ambulatory over conventional BP. Over 10.6 years (median), 1271 participants (15.0%) died and 1092 (12.9%), 637 (7.5%) and 443 (5.2%) experienced a fatal or nonfatal cardiovascular, cardiac or cerebrovascular event. Adjusted for sex and age, low BMI (<20.7 kg m(-2)) predicted death (hazard ratio (HR) vs average risk, 1.52; P<0.0001) and high BMI (> or = 30.9 kg m(-2)) predicted the cardiovascular end point (HR, 1.27; P=0.006). With adjustments including 24-h systolic BP, these HRs were 1.50 (P<0.001) and 0.98 (P=0.91), respectively. Across quartiles of the BMI distribution, 24-h and nighttime systolic BP predicted every end point (1.13 < or = standardized HR < or = 1.67; 0.046 < or = P<0.0001). The interaction between systolic BP and BMI was nonsignificant (P > or = .22). Excluding smokers removed the contribution of BMI categories to the prediction of mortality. In conclusion, BMI only adds to BP in risk stratification for mortality but not for cardiovascular outcomes. Smoking probably explains the association between increased mortality and low BMI.
U2 - 10.1038/jhh.2013.145
DO - 10.1038/jhh.2013.145
M3 - Journal article
C2 - 24430701
VL - 28
SP - 535
EP - 542
JO - Journal of Human Hypertension
JF - Journal of Human Hypertension
SN - 0950-9240
IS - 9
ER -