PREDICTION OF MORTALITY BY AMBULATORY BLOOD-PRESSURE MONITORING VERSUS SCREENING BLOOD-PRESSURE MEASUREMENTS - A PILOT-STUDY IN OHASAMA

Objective To compare the prediction of mortality by ambulatory blood p ressure monitoring and screening blood pressure measurements in a gene ral population. Design A prospective cohort study. Patients and method s We obtained blood pressure data for 1542 subjects (565 men and 977 w omen) aged greater than or equal to 40 years who were followed up for up to 8.1 years (mean 5.1 years). Subjects were subdivided into five g roups according to their ambulatory and screening blood pressure level s. The prognostic significance of blood pressure for mortality was exa mined by the Cox proportional hazards regression model, Results The as sociation between blood pressure level and mortality was more distinct ive for the ambulatory blood pressure than it was for the screening bl ood pressure. The risk of cardiovascular mortality increased significa ntly for the highest quintiles of 24 h ambulatory blood pressure, wher eas there was no significant association between the screening blood p ressure and the cardiovascular mortality, When both 24 h and screening blood pressure values were included in the Cox model, only the systol ic ambulatory blood pressure was related significantly to the increase d risk of cardiovascular mortality, Conclusions The ambulatory blood p ressure had a stronger predictive power for mortality than did the scr eening blood pressure, This appears to have been the first study of th e prognostic significance of ambulatory blood pressure monitoring vers us screening blood pressure measurements in a general population.