Association of Office and Ambulatory Blood Pressure With Mortality and Cardiovascular Outcomes

Abstract

Quiz Ref ID North American,^1,2 European,^3,4 Japanese,⁵ and Chinese⁶ guidelines unanimously recommend ambulatory blood pressure (BP) monitoring for BP assessment. However, which BP index among the multitude of measurements that can be derived from conventional and ambulatory BP recordings is more closely associated with adverse health outcomes remains unresolved. In several studies, the association between cardiovascular risk and BP was strongest for systolic readings taken at nighttime,⁷ an observation subsequently replicated among patients with hypertension⁸ or referred for ambulatory BP monitoring.⁹ More recently,¹⁰ BP readings via automated office machines was introduced as an alternative to ambulatory monitoring, but the strength of its association with a cardiovascular outcome is unknown. Given the uncertainty left by these previous findings,^7-13 the objective of this study was to evaluate various types of BP measurements and assess the strength of their associations with mortality and adverse cardiovascular outcomes.