Published Online
on September 18, 2006

A more recent version of this article appeared on November 1, 2006

This Article Full Text (PDF) All Versions of this Article: 48/5/877    most recent 01.HYP.0000242285.83728.eev1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Inoue, R. Articles by Imai, Y. Search for Related Content PubMed PubMed Citation Articles by Inoue, R. Articles by Imai, Y. Related Collections Cerebrovascular disease/stroke

Submitted on February 14, 2006
Revised on March 4, 2006

Predicting Stroke Using Four Ambulatory Blood Pressure Monitoring-Derived Blood Pressure Indices. The Ohasama Study

Ryusuke Inoue; Takayoshi Ohkubo^*; Masahiro Kikuya; Hirohito Metoki; Kei Asayama; Taku Obara; Haruhisa Hoshi; Junichiro Hashimoto; Kazuhito Tostune; Hiroshi Satoh; Yoshiaki Kondo; and Yutaka Imai

From the Tohoku University 21st Century Center of Excellence Program Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation "CRESCENDO" (R.I., T.O., H.M., K.A., J.H., K.T., H.S., K.Y., Y.I.), Department of Clinical Pharmacology and Therapeutics (H.M., K.A., T.O., K.T., Y.I.), and Drug Development and Clinical Evaluation (T.O., M.K., J.H.), Environmental Health Sciences (H.S.), Tohoku University Graduate School of Pharmaceutical Science and Medicine, Comprehensive Research and Education Center for Planning of Drug Development and Clinical Evaluation, Sendai, Japan; and Ohasama Hospital (H.H.), Iwate, Japan.

^* To whom correspondence should be addressed. E-mail: tohkubo{at}mail.tains.tohoku.ac.jp.

Abstract--We investigated the association between stroke and blood pressure (BP) indices (systolic BP [SBP], diastolic BP [DBP], mean BP [MBP], and pulse pressure [PP]) determined by ambulatory BP monitoring. The predictive power for stroke of these indices was compared in the general Japanese population. We obtained ambulatory BP data in 1271 subjects (40% men) aged 40 (mean: 61) years. During a mean follow-up of 11 years, 113 strokes were observed. The multivariate adjusted relative hazard and likelihood ratio for a 1-SD increase for each BP index was determined by Cox proportional hazard regression. Comparison of the likelihood ratio between Cox models including 2 indices and those including 1 index indicated that PP was significantly less informative than other indices (P<0.01 when adding MBP, SBP, or DBP to the PP model; P>0.09 when adding PP to the model including another index). However, after removing age from covariates, PP became more informative than DBP and MBP (P<0.0001 when adding PP to the MBP or DBP model, whereas SBP was more informative than PP even after removing age; P<0.05 when adding SBP to the PP model). In conclusion, PP was the weakest predictor of stroke. Exclusion of age from covariates increased the predictive power of PP, suggesting that the stroke risk associated with PP reflected the risk of aging per se.

Key words: ambulatory blood pressure monitoring • pulse pressure • systolic blood pressure • diastolic blood pressure • mean blood/arterial pressure • stroke

This article has been cited by other articles:

				S. Homma, G. D. Sloop, and A. W. Zieske The Effect of Age and Other Atherosclerotic Risk Factors on Carotid Artery Blood Velocity in Individuals Ranging From Young Adults to Centenarians Angiology, October 1, 2009; 60(5): 637 - 643. [Abstract] [PDF]

				R. Inoue, T. Ohkubo, M. Kikuya, H. Metoki, K. Asayama, A. Kanno, T. Obara, T. Hirose, A. Hara, H. Hoshi, et al. Stroke Risk of Blood Pressure Indices Determined by Home Blood Pressure Measurement: The Ohasama Study Stroke, August 1, 2009; 40(8): 2859 - 2861. [Abstract] [Full Text] [PDF]

				K. Miura, H. Nakagawa, Y. Ohashi, A. Harada, M. Taguri, T. Kushiro, A. Takahashi, M. Nishinaga, H. Soejima, H. Ueshima, et al. Four Blood Pressure Indexes and the Risk of Stroke and Myocardial Infarction in Japanese Men and Women: A Meta-Analysis of 16 Cohort Studies Circulation, April 14, 2009; 119(14): 1892 - 1898. [Abstract] [Full Text] [PDF]