Nighttime ambulatory pulse pressure predicts cardiovascular and all‐cause mortality among middle‐aged participants in the 21‐year follow‐up

Lempiäinen, Päivi A; Ylitalo, Antti; Huikuri, Heikki V.; Kesäniemi, Y. Antero; Ukkola, Olavi

doi:10.1111/jch.14317

Cited by 3 publications

(3 citation statements)

References 40 publications

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“…Beyond its independent association with arterial stiffness and critical hypoperfusion of diastolic flow-dependent organs, recent studies have linked nPP to a pro-inflammatory internal milieu and an unfavorable redox status. These abnormalities promote a sequence of deleterious metabolic effects on the cardiovascular system, potentially including concurrent lipid profile abnormalities [47][48][49] .…”

Section: Discussionmentioning

confidence: 99%

Assessing the relationship between lipoprotein(a) levels and blood pressure among hypertensive patients beyond conventional measures. An observational study

Vazquez-Agra,

Cruces-Sande,

Barbosa-Gouveia

et al. 2024

Sci Rep

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High lipoprotein(a) (Lp(a)) levels are associated with an increased risk of arterial hypertension (AHT) and atherosclerotic cardiovascular disease. However, little is known about the detailed profile of AHT based on Lp(a) levels. This observational study focused on elucidating the relationship between Lp(a) concentrations and specific indices obtained from 24-h ambulatory blood pressure (BP) monitoring in hypertensive patients over 18 years of age. We gathered and analyzed data on BP indices along with demographic, epidemiological, clinical, and laboratory variables from 227 hypertensive patients, median age 56 years, including 127 women (56%). After comparing hypertensive patients with Lp(a) levels above and below 125 nmol/L, we found that a 10 mmHg increase in nocturnal systolic BP and all pulse pressure indices (24-h, daytime, and night-time) was associated with an increased risk of high Lp(a) levels by more than 20% and 40%, respectively. Similarly, each 10% increase in the area under the function over time of nocturnal diastolic BP dipping was associated with more than a 30% decrease in the odds of belonging to the elevated Lp(a) levels category. Additionally, Lp(a) levels above 125 nmol/L were associated with higher 24-h, daytime, and night-time systolic BP and pulse pressure load. The relationship between Lp(a) and AHT appears to extend beyond conventional BP measurements, which may be relevant given the prognostic implications of nocturnal BP and pulse pressure indices.

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Section: Discussionmentioning

confidence: 99%

Assessing the relationship between lipoprotein(a) levels and blood pressure among hypertensive patients beyond conventional measures. An observational study

Vazquez-Agra,

Cruces-Sande,

Barbosa-Gouveia

et al. 2024

Sci Rep

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show abstract

“…In both the stated studies, PP was not examined. Lempiäinen et al [52] studied 1045 arterial hypertension patients undergoing ABPM (56.7% with a CV event). According to their findings, middle-aged people's high nighttime PP was the most accurate ambulatory BP indicator of CV and all-cause mortality [52].…”

Section: Discussionmentioning

confidence: 99%

“…Lempiäinen et al [52] studied 1045 arterial hypertension patients undergoing ABPM (56.7% with a CV event). According to their findings, middle-aged people's high nighttime PP was the most accurate ambulatory BP indicator of CV and all-cause mortality [52]. The same was noted in studies on populations with essential hypertension [28,29].…”

Section: Discussionmentioning

confidence: 99%

Systolic Blood Pressure and Pulse Pressure Are Predictors of Future Cardiovascular Events in Patients with True Resistant Hypertension

et al. 2023

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Given the increased risk of cardiovascular events associated with resistant hypertension, predictive cardiovascular prognosis is extremely important. Ambulatory blood pressure monitoring (ABPM) is mandatory for resistant hypertension diagnosis, but its use for prognosis is scarce. This observational longitudinal study included 258 patients (mean age of 60.4 ± 11.2 years; 61.2% male), who underwent 24 h ABPM in a hypertension unit from 1999 to 2019. The outcomes were global cardiovascular events (cerebrovascular, coronary, and other cardiovascular events). The mean follow-up period was 6.0 ± 5.0 years. Sixty-eight cardiovascular events (61 nonfatal) were recorded. Patients who experienced cardiovascular events were generally older, with higher rates of chronic kidney disease and prior cardiovascular events. The 24 h systolic blood pressure (hazard ratio 1.44; 95% CI 1.10–1.88), night systolic blood pressure (1.35; 95% CI 1.01–1.80), and 24 h pulse pressure (2.07; 95% CI 1.17–3.67) were independent predictors of global cardiovascular events. Multivariate Cox analysis revealed a higher risk of future cardiovascular events, particularly in patients with a 24 h daytime and nighttime pulse pressure > 60 mm Hg with respective hazard ratios of 1.95; 95% CI 1.01–3.45; 2.15; 95% CI 1.21–3.83 and 2.07; 95% CI 1.17–3.67. In conclusion, APBM is a fundamental tool not only for the diagnosis of resistant hypertension, but also for predicting future cardiovascular events.

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The contribution of cumulative blood pressure load to dementia, cognitive function and mortality in older adults

Xu,

Catts,

Harris

et al. 2024

Journal of Hypertension

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Background: Few studies evaluated the contribution of long-term elevated blood pressure (BP) towards dementia and deaths. We examined the association between cumulative BP (cBP) load and dementia, cognitive decline, all-cause and cardiovascular deaths in older Australians. We also explored whether seated versus standing BP were associated with these outcomes. Methods: The Sydney Memory and Aging Study included 1037 community-dwelling individuals aged 70–90 years, recruited from Sydney, Australia. Baseline data was collected in 2005–2007 and the cohort was followed for seven waves until 2021. cSBP load was calculated as the area under the curve (AUC) for SBP ≥140 mmHg divided by the AUC for all SBP values. Cumulative diastolic BP (cDBP) and pulse pressure (cPP) load were calculated using thresholds of 90 mmHg and 60 mmHg. Cox and mixed linear models were used to assess associations. Results: Of 527 participants with both seated and standing BP data (47.7% men, median age 77), 152 (28.8%) developed dementia over a mean follow-up of 10.5 years. Higher cPP load was associated with a higher risk of all-cause deaths, and cSBP load was associated with a higher risk of cardiovascular deaths in multivariate models (P for trend < 0.05). Associations between cPP load, dementia and cognitive decline lost statistical significance after adjustment for age. Differences between sitting and standing BP load were not associated with the outcomes. Conclusion: Long-term cPP load was associated with a higher risk of all-cause deaths and cSBP load associated with a higher risk of cardiovascular deaths in older Australians.

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Nighttime ambulatory pulse pressure predicts cardiovascular and all‐cause mortality among middle‐aged participants in the 21‐year follow‐up

Cited by 3 publications

References 40 publications

Assessing the relationship between lipoprotein(a) levels and blood pressure among hypertensive patients beyond conventional measures. An observational study

Assessing the relationship between lipoprotein(a) levels and blood pressure among hypertensive patients beyond conventional measures. An observational study

Systolic Blood Pressure and Pulse Pressure Are Predictors of Future Cardiovascular Events in Patients with True Resistant Hypertension

The contribution of cumulative blood pressure load to dementia, cognitive function and mortality in older adults

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