The International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome (IDACO): protocol and research perspectives

Thijs, Lutgarde; Hansen, Tine W.; Kikuya, Masahiro; Björklund-Bodegård, Kristina; Y, Li; Dolan, Eamon; Tikhonoff, Valérie; Seidlerová, Jitka; Kuznetsova, Tatiana; Stolarz, Katarzyna; Bianchi, Manuel Alva; Richart, Tom; Casíglia, Edoardo; Malyutina, Sofia; Filipovský, Jan; Kawecka‐Jaszcz, K.; Nikitin, Yu. P.; Ohkubo, Takayoshi; Sandoya, Edgardo; Wang, J; Torp‐Pedersen, Christian; Lind, Lars; Ibsen, Hans; Imai, Yutaka; Staessen, Jan A.; O’Brien, Eoin; Investigators, Idaco

doi:10.1097/mbp.0b013e3280f813bc

Cited by 132 publications

(163 citation statements)

References 45 publications

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“…1,[13][14][15] Studies were eligible for inclusion if they involved a random population sample, if baseline information on ambulatory blood pressure and cardiovascular risk factors was available, and if the subsequent follow-up included fatal and nonfatal outcomes. At the time of writing this report, the International Database on Ambulatory Blood Pressure in Relation to Cardiovascular Outcome included prospective studies from 11 centers (11 785 subjects).…”

Section: Study Populationmentioning

confidence: 99%

Prognostic Value of Reading-to-Reading Blood Pressure Variability Over 24 Hours in 8938 Subjects From 11 Populations

et al. 2010

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Abstract-In previous studies, of which several were underpowered, the relation between cardiovascular outcome and blood pressure (BP) variability was inconsistent. We followed health outcomes in 8938 subjects (mean age: 53.0 years; 46.8% women) randomly recruited from 11 populations. At baseline, we assessed BP variability from the SD and average real variability in 24-hour ambulatory BP recordings. We computed standardized hazard ratios (HRs) while stratifying by cohort and adjusting for 24-hour BP and other risk factors. Over 11.3 years (median), 1242 deaths (487 cardiovascular) occurred, and 1049, 577, 421, and 457 participants experienced a fatal or nonfatal cardiovascular, cardiac, or coronary event or a stroke.Higher diastolic average real variability in 24-hour ambulatory BP recordings predicted (PՅ0.03) total (HR: 1.14) and cardiovascular (HR: 1.21) mortality and all types of fatal combined with nonfatal end points (HR: Ն1.07) with the exception of cardiac and coronary events (HR: Յ1.02; PՆ0.58). Higher systolic average real variability in 24-hour ambulatory BP recordings predicted (PϽ0.05) total (HR: 1.11) and cardiovascular (HR: 1.16) mortality and all fatal combined with nonfatal end points (HR: Ն1.07), with the exception of cardiac and coronary events (HR: Յ1.03; PՆ0.54). SD predicted only total and cardiovascular mortality. While accounting for the 24-hour BP level, average real variability in 24-hour ambulatory BP recordings added Ͻ1% to the prediction of a cardiovascular event. Sensitivity analyses considering ethnicity, sex, age, previous cardiovascular disease, antihypertensive treatment, number of BP readings per recording, or the night:day BP ratio were confirmatory. In conclusion, in a large population cohort, which provided sufficient statistical power, BP variability assessed from 24-hour ambulatory recordings did not contribute much to risk stratification over and beyond 24-hour BP. (Hypertension. 2010;55:1049-1057.)Key Words: blood pressure variability Ⅲ ambulatory blood pressure Ⅲ population science Ⅲ risk factors Ⅲ epidemiology A mbulatory blood pressure monitoring not only provides information on the blood pressure level but on the diurnal changes in blood pressure as well. Blood pressure variability includes both short-term and circadian components, which can be estimated by the SD of the blood pressure values over a defined period of the day or by the night:day blood pressure ratio, respectively. We recently reported in Ͼ7000 subjects recruited from 6 populations on the prognos- Although the aforementioned analyses shed light on the association between outcome and long-term blood pressure variability, the predictive value of short-term reading-toreading blood pressure variability remains uncertain. Possible limitations of previous studies were a lack of statistical power, 2-5 selection of specific groups of patients, 5-7 categorization of variability by arbitrary cutoff points, 2,4,7-9 and sole reliance on fatal end points. 10,11 Moreover, various parameters can capture short-term b...

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Section: Study Populationmentioning

confidence: 99%

Prognostic Value of Reading-to-Reading Blood Pressure Variability Over 24 Hours in 8938 Subjects From 11 Populations

et al. 2010

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“…A worldwide consortium of investigators are currently enlarging the database of ambulatory BP recordings in relation to cardiovascular outcomes and plan to study the predictive value of AASI in population-based cohorts of different ethnicity. 38 In the meantime, manufacturers of devices for ABPM are including the computation of AASI in their software packages. Clinicians might consider AASI in the risk stratification of their patients under the proviso that further clinical and epidemiological validation of this novel prognostic index of arterial function is warranted.…”

Section: Discussionmentioning

confidence: 99%

Responses of the ambulatory arterial stiffness index and other measures of arterial function to antihypertensive drugs

et al. 2011

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on behalf of the REASON InvestigatorsWe investigated the effects of different antihypertensive drugs on the ambulatory arterial stiffness index (AASI), pulse pressure (PP), the arterio-ventricular coupling index (AVCI) and aortic pulse wave velocity (aPWV). After a 4-week placebo period, 94 and 107 patients with uncomplicated hypertension were randomly assigned to treatment with atenolol (AT) at dosage of 50 mg per day or perindopril/indapamide (PER/IND) at dosage of 2/0.6 mg per day for 1 year. From each patient's 24-h ambulatory blood pressure (BP) recording, we determined the 24-h systolic and diastolic BPs. We computed PP as the difference between 24-h systolic and diastolic BP, AASI as unity minus the regression slope of diastolic on systolic BP, and AVCI as (T/s)/(1+2T/3s), where T is the heart period in seconds and s is the decay time of aortic BP during diastole. On AT compared with PER/IND, with adjustments applied for covariables, 24-h systolic BP (À9.5 vs. À13.7 mm Hg; P¼0.009) and 24-h PP (À1.02 vs. À6.53 mm Hg; Po0.001) decreased less and AVCI lengthened more (+0.019 vs. À0.008; Po0.001). The changes in AASI (À0.001 vs. À0.014; P¼0.44) and aPWV (À0.89 vs. À0.69 m s À1 ; P¼0.45) were similar in the two treatment groups. AASI and aPWV showed significant concordance (r¼0.21, P¼0.003) after adjustment for covariables. On administration of antihypertensive drugs with different hemodynamic profiles, AASI and aPWV behaved similarly. The similarity in the findings for aPWV and AASI support the use of AASI as an index reflecting the arterial stiffness.

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“…Details about study selection and aims of the consortium have been described previously. 8 Currently, the IDACO database contains 12 randomly recruited population cohorts and 12 725 participants. For the purpose of this analysis, we excluded 303 participants aged <18 years, 1389 with missing CBPM, 1878 with incomplete ABPM (<10 valid daytime measurements or <5 valid nighttime measurements), 8 and 1649 participants currently taking antihypertensive treatment, such that 7506 IDACO participants were included in this study.…”

Section: Methodsmentioning

confidence: 99%

Age-Specific Differences Between Conventional and Ambulatory Daytime Blood Pressure Values

et al. 2014

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The International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome (IDACO): protocol and research perspectives

Abstract: The international database of ambulatory blood pressure in relation to cardiovascular outcome will provide a shared resource to investigate risk stratification by ambulatory blood pressure monitoring to an extent not possible in any earlier individual study.

Cited by 132 publications

References 45 publications

Prognostic Value of Reading-to-Reading Blood Pressure Variability Over 24 Hours in 8938 Subjects From 11 Populations

Prognostic Value of Reading-to-Reading Blood Pressure Variability Over 24 Hours in 8938 Subjects From 11 Populations

Responses of the ambulatory arterial stiffness index and other measures of arterial function to antihypertensive drugs

Age-Specific Differences Between Conventional and Ambulatory Daytime Blood Pressure Values

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