Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population: Follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study

Roberto Sega, Rita Facchetti, Michele Bombelli, Giancarlo Cesana, Giovanni Corrao, Guido Grassi, Giuseppe Mancia

Research output: Contribution to journalArticle

706 Citations (Scopus)

Abstract

Background - Studies in hypertensive patients suggest that ambulatory blood pressure (BP) is prognostically superior to office BP. Much less information is available in the general population, however. Obtaining this information was the purpose of the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Methods and Results - Office, home, and 24-hour ambulatory BP values were obtained in 2051 subjects between 25 and 74 years of age who were representative of the general population of Monza (Milan, Italy). Subjects were followed up for an average of 131 months, during which time cardiovascular and noncardiovascular fatal events were recorded (n=186). Office, home, and ambulatory BP values showed a significant exponential direct relationship with risk of cardiovascular or all-cause death. The goodness of fit of the relationship was greater for systolic than for diastolic BP and for night than for day BP, but its overall value was not better for home or ambulatory than for office BP. The slope of the relationship, however, was progressively greater from office to home and ambulatory BP. Home and night BP modestly improved the goodness of fit of the risk model when added to office BP. Conclusions - In the PAMELA population, risk of death increased more with a given increase in home or ambulatory than in office BP. The overall ability to predict death, however, was not greater for home and ambulatory than for office BP, although it was somewhat increased by the combination of office and outside-of-office values. Systolic BP was almost invariably superior to diastolic BP, and night BP was superior to day BP.

Original languageEnglish
Pages (from-to)1777-1783
Number of pages7
JournalCirculation
Volume111
Issue number14
DOIs
Publication statusPublished - Apr 12 2005

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Blood Pressure
Population
Italy
Cause of Death

Keywords

  • Blood pressure monitoring
  • Heart rate
  • Mortality

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population : Follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. / Sega, Roberto; Facchetti, Rita; Bombelli, Michele; Cesana, Giancarlo; Corrao, Giovanni; Grassi, Guido; Mancia, Giuseppe.

In: Circulation, Vol. 111, No. 14, 12.04.2005, p. 1777-1783.

Research output: Contribution to journalArticle

Sega, Roberto ; Facchetti, Rita ; Bombelli, Michele ; Cesana, Giancarlo ; Corrao, Giovanni ; Grassi, Guido ; Mancia, Giuseppe. / Prognostic value of ambulatory and home blood pressures compared with office blood pressure in the general population : Follow-up results from the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. In: Circulation. 2005 ; Vol. 111, No. 14. pp. 1777-1783.
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AU - Facchetti, Rita

AU - Bombelli, Michele

AU - Cesana, Giancarlo

AU - Corrao, Giovanni

AU - Grassi, Guido

AU - Mancia, Giuseppe

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