As our readers may be aware, despite the considerable attention given to oncology trials, the leading cause of death in Western countries remains cardiovascular events. High blood pressure, which affects approximately one in every two adults residing in Western nations, stands as a significant contributor to both morbidity and mortality.

Ambulatory blood pressure monitoring offers a more comprehensive evaluation compared to clinic-based blood pressure readings. Studies have indicated its superior predictive value for health outcomes when compared to measurements taken in clinical or home settings. In this study, the authors aimed to investigate the associations between clinic-based and 24-hour ambulatory blood pressure readings with regards to all-cause and cardiovascular mortality. They conducted an observational cohort study, utilizing data from March 1, 2004, to December 31, 2014, obtained from the Spanish Ambulatory Blood Pressure Registry. This registry encompassed patients from 223 primary care centers within the Spanish National Health System, spanning all 17 regions of Spain.

Mortality data, including dates and causes of death, were gathered through computerized searches of the vital registry maintained by the Spanish National Institute of Statistics. The dataset included complete information on age, gender, all blood pressure measurements, and BMI for each participant. Follow-up for each study participant extended from their recruitment date until the date of death or December 31, 2019, whichever came first. To estimate associations between conventional clinic-based blood pressure readings, ambulatory blood pressure measurements, and mortality, Cox models were employed. These models were adjusted for potential confounding variables and also considered alternative blood pressure metrics. For each blood pressure measurement, participants were categorized into five groups (i.e., quintiles) based on their respective measure, and this categorization was applied to those who subsequently passed away.1

Read the article here.

References

  1. Staplin, N., De La Sierra, A., Ruilope, L., Emberson, J., Vinyoles, E., Gorostidi, M., Ruiz-Hurtado, G., Segura, J., Baigent, C., & Williams, B. (2023). Relationship between clinic and ambulatory blood pressure and mortality: an observational cohort study in 59 124 patients. The Lancet, 401(10393), 2041–2050. https://doi.org/10.1016/s0140-6736(23)00733-x

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