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January 26, 2000

Predicting Cardiovascular Risk Using Ambulatory Blood Pressure

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(4):475-476. doi:10.1001/jama.283.4.475

To the Editor: Dr Staessen and colleagues1 reported that 24-hour ambulatory systolic blood pressure (BP) was linearly related to cardiovascular risk in older patients with untreated isolated systolic hypertension. In a previous study of 1542 residents aged 40 years or older in a rural Japanese community, we found that the relationship between 6-year total mortality risk and 24-hour BP was significantly better fitted to a second-degree equation than to a linear equation model, and that this curvilinear relationship persisted after cumulative adjustment for possible cardiovascular risk factors.2 We also reported that the right and left sides of the curvilinear relationship were related to increased risk of cardiovascular and noncardiovascular mortality, respectively. With regard to our study, Staessen et al commented, ". . . the Japanese group did not report whether the correlation remained after adjusting for the conventional BP at baseline or after excluding the noncardiovascular deaths."1