From the Departments of Public Health (T.O., I.T., S.H.), Medicine (Y.I.,
S.I.), and Environmental Health Science (H.S.), Tohoku University School of
Medicine, Sendai; and the Department of Medicine, Ohasama Hospital, Iwate
(K.N.), Japan.
Correspondence to Takayoshi Ohkubo, MD, Department of Public Health, Tohoku University School of Medicine, Sendai, 980–8575, Japan. E-mail tohkubo{at}mail.cc.tohoku.ac.jp
Abstract—Although reference
values for ambulatory blood pressure (ABP) monitoring have been
investigated in several population studies, these values were derived
from cross-sectional observations and were based merely on the
statistical distribution of blood pressure values. Therefore, we
conducted a prospective cohort study to identify reference values for
24-hour ABP in relation to prognosis. We obtained measurements of
24-hour ABP for 1542 subjects (565 men) aged 40 years and over in a
general population of a rural Japanese community and then followed-up
their survival status. There were 117 deaths during the follow-up
period (mean, 6.2 years). The association between baseline 24-hour ABP
values and mortality, examined by the Cox proportional hazards
regression model adjusted for possible confounding factors, showed a
better fit with a second-degree equation than with a first-degree
equation. On the basis of the results of this analysis, we
identified the following reference values as the optimal blood pressure
ranges that predict the best prognosis: 120 to 133 mm Hg for
systolic blood pressure and 65 to 78 mm Hg for
diastolic blood pressure. 24-Hour ABP values >134/79
mm Hg and <119/64 mm Hg were related to increased risks for
cardiovascular and noncardiovascular
mortality, respectively. This is the first report to propose reference
values for 24-hour ABP based on a prognostic criterion.
© 1998 American Heart Association, Inc.
Scientific Contributions
Reference Values for 24-Hour Ambulatory Blood Pressure Monitoring Based on a Prognostic Criterion
The Ohasama Study
Key Words: blood pressure, ambulatory • reference values • mortality • prospective studies • Japanese population
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