Home Blood Pressure Level, Blood Pressure Variability, Smoking, and Stroke Risk in Japanese Men: The Ohasama Study

Hashimoto, Takanao; Kikuya, Masahiro; Satoh, Michihiro; Metoki, Hirohito; Inoue, Ryusuke; Asayama, Kei; Kanno, Atsuhiro; Obara, Taku; Hirose, Takuo; Hara, Azusa; Hoshi, Hiroyuki; Totsune, Kazuhito; Satoh, Hiroshi; Sato, Hiroshi; Imai, Yutaka

doi:10.1038/ajh.2012.62

Cited by 37 publications

(24 citation statements)

References 41 publications

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“…A total of 846 potential eligible publications were identified, which were narrowed by preliminary review to 41 relevant original articles. Then, several investigations were further excluded because of the cross‐sectional study design (n=11) or report of the endpoints other than cardiovascular events or death (n=15) or without a conventional index for SBPV (n=1) or home BPV (n=2) . Finally, 13 longitudinal studies assessing the association of cardiovascular events and all‐cause mortality with visit‐to‐visit SBPV were deemed eligible for the meta‐analysis .…”

Section: Resultsmentioning

confidence: 99%

Prognostic Significance of Visit‐to‐Visit Systolic Blood Pressure Variability: A Meta‐Analysis of 77,299 Patients

Tai

Sun

Dai

et al. 2015

J of Clinical Hypertension

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In recent clinical investigations, visit-to-visit systolic blood pressure (SBP) variability was proven as a predictor of cardiovascular events and all-cause mortality. However, inconsistent results exist in this association. A meta-analysis of 13 prospective studies was conducted to evaluate the prognostic value of visit-to-visit SBP variability by different parameters in 77,299 patients with a mean follow-up of 6.3 years. The pooled age-and mean SBP-adjusted hazard ratios (HRs) for all-cause mortality were 1.03 (95% confidence interval [CI], 1.02-1.04; P<.001) per 1-mm Hg increase in SBP standard deviation (SD) and 1.04 (1.02-1.06, P<.001) per 1% in SBP coefficient of variation, and the corresponding values of cardiovascular mortality were 1.10 (1.02-1.17, P<.001) and 1.01 (0.99-1.03, P=.32), respectively. Moreover, a 1-mm Hg increase in SD was significantly associated with stroke, with an HR of 1.02 (1.01-1.03, P<.001). Visit-to-visit SBP variability, independent of age and mean SBP, is a predictor of cardiovascular and all-cause mortality and stroke.

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Section: Resultsmentioning

confidence: 99%

Prognostic Significance of Visit‐to‐Visit Systolic Blood Pressure Variability: A Meta‐Analysis of 77,299 Patients

Tai

Sun

Dai

et al. 2015

J of Clinical Hypertension

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show abstract

“…Although a lot of studies have showed the positive association between systolic blood pressure (SBP) and the risk of stroke occurrence [4], little is known about the relationship between SBP measured by EMS personnel and the risk of stroke occurrence among patients with impaired consciousness.…”

Section: Introductionmentioning

confidence: 99%

An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings

et al. 2013

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BackgroundStroke is difficult to diagnose when consciousness is disturbed. However few reports have discussed the clinical predictors of stroke in out-of-hospital emergency settings. This study aims to evaluate the association between initial systolic blood pressure (SBP) value measured by emergency medical service (EMS) and diagnosis of stroke among impaired consciousness patients.MethodsWe included all patients aged 18 years or older who were treated and transported by EMS, and had impaired consciousness (Japan Coma Scale ≧ 1) in Osaka City (2.7 million), Japan from January 1, 1998 through December 31, 2007. Data were prospectively collected by EMS personnel using a study-specific case report form. Multiple logistic regressions assessed the relationship between initial SBP and stroke and its subtypes adjusted for possible confounding factors.ResultsDuring these 10 years, a total of 1,840,784 emergency patients who were treated and transported by EMS were documented during the study period in Osaka City. Out of 128,678 with impaired consciousness, 106,706 who had prehospital SBP measurements in the field were eligible for our analyses. The proportion of patients with severe impaired consciousness significantly increased from 14.5% in the <100 mmHg SBP group to 27.6% in the > =200 mmHg SBP group (P for trend <0.001). The occurrence of stroke significantly increased with increasing SBP (adjusted odd ratio [AOR] 1.34, 95% confidence interval [CI] 1.33 to 1.35), and the AOR of the SBP > =200 mmHg group versus the SBP 101-120 mmHg group was 5.26 (95% CI 4.93 to 5.60). The AOR of the SBP > =200 mmHg group versus the SBP 101-120 mmHg group was 9.76 in subarachnoid hemorrhage (SAH), 16.16 in intracranial hemorrhage (ICH), and 1.52 in ischemic stroke (IS), and the AOR of SAH and ICH was greater than that of IS.ConclusionsElevated SBP among emergency patients with impaired consciousness in the field was associated with increased diagnosis of stroke.

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“…The Ohasama study showed that selfmeasurement of SBP levels and their day-by-day variability were significantly associated with the incidence of cerebral infarction in men without a history of stroke [21]. Similarly, they showed that increased day-by-day SBP variability was associated with increased hazard ratios for stroke mortality in the general population [22].…”

Section: Discussionmentioning

confidence: 97%

Aortic arch atherosclerosis in patients with severe aortic stenosis can be argued by greater day-by-day blood pressure variability

Iwata¹,

Sugioka²,

Fujita³

et al. 2015

Atherosclerosis

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Home Blood Pressure Level, Blood Pressure Variability, Smoking, and Stroke Risk in Japanese Men: The Ohasama Study

Abstract: In ever smokers, both HBP levels and variability are significantly associated with the risk of cerebral infarction. Our findings further validate the benefit of smoking cessation in preventing cardiovascular disease (CVD), especially cerebral infarction.

Cited by 37 publications

References 41 publications

Prognostic Significance of Visit‐to‐Visit Systolic Blood Pressure Variability: A Meta‐Analysis of 77,299 Patients

Prognostic Significance of Visit‐to‐Visit Systolic Blood Pressure Variability: A Meta‐Analysis of 77,299 Patients

An association between systolic blood pressure and stroke among patients with impaired consciousness in out-of-hospital emergency settings

Aortic arch atherosclerosis in patients with severe aortic stenosis can be argued by greater day-by-day blood pressure variability

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