Τίτλος:
Association of Ambulatory Blood Pressure Monitoring parameters with the Framingham Stroke Risk Profile
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
The Framingham Stroke Risk Profile (FSRP) is a novel and reliable tool for estimating the 10-year probability for incident stroke in stroke-free individuals, while the predictive value of ambulatory blood pressure monitoring (ABPM) for first-ever and recurrent stroke has been well established. We sought to evaluate cross-sectionally the association of ABPM parameters with FSRP score in a large sample of 2343 consecutive stroke-free individuals (mean age: 56.0 ± 12.9, 49.1% male) who underwent 24-hour ABPM. True hypertensives showed significantly higher FSRP (11.2 ± 5.0) compared to the normotensives (8.2 ± 5.0, p < 0.001), while subjects with white coat hypertension also had higher FSRP (10.2 ± 4.7) than normotensives (8.2 ± 5.0, p < 0.001). Compared to dippers that exhibited the lowest FSRP, non-dippers and reverse-dippers exhibited significantly higher FSRP (9.8 ± 4.8 for dippers vs 10.6 ± 5.2 and 11.5 ± 5.0 for non-dippers and reverse-dippers respectively, p ≤ 0.001 for comparisons). In univariate analyses, the ABPM parameters that had the strongest correlation with FSRP were 24-hour (r = 0.440, p < 0.001), daytime (r = 0.435, p < 0.001) and night-time (r = 0.423; p < 0.001) pulse pressure (PP). The best fitting model for predicting FSRP (R2 = 24.6%) on multiple linear regression analyses after adjustment for vascular risk factors not included in FSRP comprised the following parameters in descending order: 24-hour PP (β = 0.349, p < 0.001), daytime SBP variability (β = 0.124, p < 0.001), 24-hour HR variability (β = − 0.091, p < 0.001), mean 24-hour HR (β = − 0.107, p < 0.001), BMI (β = 0.081, p < 0.001) and dipping percentage (β = − 0.063, p = 0.001). 24-hour PP and daytime SBP variability are the two ABPM parameters that were more strongly associated with FSRP-score. Reverse dippers had the highest FSRP among all dipping status profiles. © 2017 Elsevier B.V.
Συγγραφείς:
Tsivgoulis, G.
Pikilidou, M.
Katsanos, A.H.
Stamatelopoulos, K.
Michas, F.
Lykka, A.
Zompola, C.
Filippatou, A.
Boviatsis, E.
Voumvourakis, K.
Zakopoulos, N.
Manios, E.
Περιοδικό:
Journal of the Neurological Sciences
Λέξεις-κλειδιά:
adult; Article; blood pressure monitoring; cardiovascular risk; cerebrovascular accident; comparative study; correlation analysis; cross-sectional study; diastolic blood pressure; female; Framingham risk score; framingham stroke risk profile; heart rate variability; human; major clinical study; male; masked hypertension; middle aged; priority journal; pulse pressure; systolic blood pressure; systolic hypertension; white coat hypertension; adolescent; aged; Caucasian; cerebrovascular accident; hypertension; multivariate analysis; pathophysiology; photoperiodicity; risk assessment; risk factor; statistical model; very elderly; young adult, Adolescent; Adult; Aged; Aged, 80 and over; Blood Pressure Monitoring, Ambulatory; Cross-Sectional Studies; European Continental Ancestry Group; Female; Humans; Hypertension; Linear Models; Male; Middle Aged; Multivariate Analysis; Photoperiod; Risk Assessment; Risk Factors; Stroke; Young Adult
DOI:
10.1016/j.jns.2017.07.007
