Predictive Accuracy of 24-Hour Ambulatory Blood Pressure Monitoring Versus Clinic Blood Pressure for Cardiovascular and All-Cause Mortality: A Systematic Review and Meta-Analysis.

IF 1.5 Q3 PERIPHERAL VASCULAR DISEASE

Current Hypertension Reviews Pub Date : 2025-02-11 DOI:10.2174/0115734021337639250203175636

Hamidreza Soleimani, Negin Sadat Hosseini Mohammadi, Sara Montazeri Namin, Amir Nasrollahizadeh, Tara Azardar, Kimia Najafi, Mehmet Cilingiroglu, Mushabbar Syed, Mani K Askari, Rahul Gupta, Wilbert S Aronow, Kaveh Hosseini

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引用次数: 0

Abstract

Background: According to current clinical practice guidelines, ambulatory blood pressure measurement (ABPM) is recommended to confirm diagnoses of hypertension. It remains unclear as to which method is superior in predicting mortality outcomes.

Methods: Prospective observational studies, comparing ABPM with clinical blood pressure measurements (CBPM), were included with outcomes of the study being all-cause and cardiovascular mortality.

Results: Nine studies with a total of 23,140 participants were included. Each 10-mmHg increase in 24-hour mean systolic blood pressure (SBP) was linked to a higher risk of all-cause mortality (HR: 1.13, 95% CI: 1.09-1.18), while clinic blood pressure measurement (CBPM) was not a significant predictor (HR: 1.02, 95% CI: 0.90-1.13). Nighttime SBP increases of 10 mmHg were associated with a higher all-cause mortality risk than daytime SBP (HR: 1.16, 95% CI: 1.11-1.21 versus HR: 1.08, 95% CI: 1.05-1.12). For cardiovascular mortality, a 10 mmHg increase in SBP yielded an HR of 1.21 (95% CI: 1.16-1.27) for 24-hour ABPM compared to 1.08 (95% CI: 1.04-1.11) for CBPM. Similarly, for a 5 mmHg increase in diastolic blood pressure (DBP), the HR was 1.14 (95% CI: 1.07-1.20) for 24-hour ABPM versus 1.04 (95% CI: 1.01-1.07) for clinical DBP, highlighting 24-hour monitoring as a stronger predictor for cardiovascular mortality.

Conclusion: The findings of this study support the superiority of ABPM measurements in predicting both all-cause and cardiovascular mortality.

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24小时动态血压监测与临床血压对心血管和全因死亡率的预测准确性：系统回顾和荟萃分析

背景：根据目前的临床实践指南，推荐动态血压测量（ABPM）来确认高血压的诊断。目前尚不清楚哪种方法在预测死亡率结果方面更优越。方法：前瞻性观察性研究，比较ABPM与临床血压测量（CBPM），研究结果为全因死亡率和心血管死亡率。结果：9项研究共纳入23140名受试者。24小时平均收缩压（SBP）每增加10mmhg与全因死亡风险增加有关（HR: 1.13, 95% CI: 1.09-1.18），而临床血压测量（CBPM）不是一个显著的预测因子（HR: 1.02, 95% CI: 0.90-1.13）。夜间收缩压升高10 mmHg与白天收缩压升高的全因死亡风险相关（HR: 1.16, 95% CI: 1.11-1.21, HR: 1.08, 95% CI: 1.05-1.12）。对于心血管死亡率，收缩压每增加10 mmHg， 24小时ABPM的HR为1.21 (95% CI: 1.16-1.27)，而CBPM的HR为1.08 （95% CI: 1.04-1.11）。同样，对于舒张压（DBP）升高5mmhg， 24小时ABPM的HR为1.14 (95% CI: 1.07-1.20)，而临床DBP的HR为1.04 (95% CI: 1.01-1.07)，强调24小时监测是心血管死亡率的更强预测因子。结论：本研究结果支持ABPM测量在预测全因死亡率和心血管死亡率方面的优越性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Hypertension Reviews PERIPHERAL VASCULAR DISEASE-

CiteScore

4.80

自引率

0.00%

发文量

期刊介绍： Current Hypertension Reviews publishes frontier reviews/ mini-reviews, original research articles and guest edited thematic issues on all the latest advances on hypertension and its related areas e.g. nephrology, clinical care, and therapy. The journal’s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all clinicians and researchers in the field of hypertension.