Thresholds for conventional and home blood pressure by sex and age in 5018 participants from 5 populations

Kyoko Nomura, Kei Asayama, Lutgarde Thijs, Teemu J. Niiranen, Inés Lujambio, José Boggia, Atsushi Hozawa, Takayoshi Ohkubo, Azusa Hara, Jouni K. Johansson, Edgardo Sandoya, Anastasios Kollias, George S. Stergiou, Ichiro Tsuji, Antti M. Jula, Yutaka Imai, Jan A. Staessen

Research output: Contribution to journalArticle

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Abstract

Whether blood pressure thresholds for hypertension should differ according to sex or age remains debated. We did a subject-level meta-analysis of 5018 people untreated for hypertension and randomly recruited from 5 populations (women, 56.7%; ≥60 years, 42.3%). We used multivariable-adjusted Cox regression and a bootstrap procedure to determine home blood pressure (HBP) levels yielding 10-year cardiovascular risks similar to those associated with established systolic/diastolic thresholds (140-160/80-100 mm Hg) for the conventional blood pressure (CBP). Conversely, we estimated CBP thresholds providing 10-year cardiovascular risks similar to those associated established HBP levels (125-135/80-85 mm Hg). All analyses were stratified for sex and age (<60 versus ≥60 years). During 8.3 years (median), 414 participants experienced a cardiovascular event. The sex differences between HBP thresholds derived from CBP and between CBP thresholds derived from HBP were all nonsignificant (P≤0.24), ranging from -4.6 to 3.6 mm Hg systolic and from -4.3 to 2.1 mm Hg diastolic. The age differences between HBP thresholds derived from CBP and between CBP thresholds derived from HBP ranged from -6.7 to 8.4 mm Hg systolic and from -1.9 to 1.7 mm Hg diastolic and were nonsignificant (P≥0.08), except for HBP thresholds derived from CBP levels of 140 mm Hg systolic and 80 mm Hg diastolic (P≤0.04). Sensitivity analyses based on cardiac or cerebrovascular complications were confirmatory. In conclusion, our findings based on outcome-driven criteria support contemporary guidelines that propose single blood pressure thresholds that can be indiscriminately applied in both sexes and across the age range.

Original languageEnglish
Pages (from-to)695-701
Number of pages7
JournalHypertension
Volume64
Issue number4
DOIs
Publication statusPublished - 2014 Jan 1
Externally publishedYes

Fingerprint

Blood Pressure
Population
Hypertension
Sex Characteristics
Meta-Analysis
Guidelines

Keywords

  • Aged
  • Classification
  • Home blood pressure monitoring
  • Population
  • Self blood pressure monitoring
  • Women

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Nomura, K., Asayama, K., Thijs, L., Niiranen, T. J., Lujambio, I., Boggia, J., ... Staessen, J. A. (2014). Thresholds for conventional and home blood pressure by sex and age in 5018 participants from 5 populations. Hypertension, 64(4), 695-701. https://doi.org/10.1161/HYPERTENSIONAHA.114.03839

Thresholds for conventional and home blood pressure by sex and age in 5018 participants from 5 populations. / Nomura, Kyoko; Asayama, Kei; Thijs, Lutgarde; Niiranen, Teemu J.; Lujambio, Inés; Boggia, José; Hozawa, Atsushi; Ohkubo, Takayoshi; Hara, Azusa; Johansson, Jouni K.; Sandoya, Edgardo; Kollias, Anastasios; Stergiou, George S.; Tsuji, Ichiro; Jula, Antti M.; Imai, Yutaka; Staessen, Jan A.

In: Hypertension, Vol. 64, No. 4, 01.01.2014, p. 695-701.

Research output: Contribution to journalArticle

Nomura, K, Asayama, K, Thijs, L, Niiranen, TJ, Lujambio, I, Boggia, J, Hozawa, A, Ohkubo, T, Hara, A, Johansson, JK, Sandoya, E, Kollias, A, Stergiou, GS, Tsuji, I, Jula, AM, Imai, Y & Staessen, JA 2014, 'Thresholds for conventional and home blood pressure by sex and age in 5018 participants from 5 populations', Hypertension, vol. 64, no. 4, pp. 695-701. https://doi.org/10.1161/HYPERTENSIONAHA.114.03839
Nomura, Kyoko ; Asayama, Kei ; Thijs, Lutgarde ; Niiranen, Teemu J. ; Lujambio, Inés ; Boggia, José ; Hozawa, Atsushi ; Ohkubo, Takayoshi ; Hara, Azusa ; Johansson, Jouni K. ; Sandoya, Edgardo ; Kollias, Anastasios ; Stergiou, George S. ; Tsuji, Ichiro ; Jula, Antti M. ; Imai, Yutaka ; Staessen, Jan A. / Thresholds for conventional and home blood pressure by sex and age in 5018 participants from 5 populations. In: Hypertension. 2014 ; Vol. 64, No. 4. pp. 695-701.
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