Risk Stratification by Self-Measured Home Blood Pressure across Categories of Conventional Blood Pressure: A Participant-Level Meta-Analysis
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{"title"=>"Risk Stratification by Self-Measured Home Blood Pressure across Categories of Conventional Blood Pressure: A Participant-Level Meta-Analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Kei", "last_name"=>"Asayama", "scopus_author_id"=>"57198403243"}, {"first_name"=>"Lutgarde", "last_name"=>"Thijs", "scopus_author_id"=>"35378587200"}, {"first_name"=>"Jana", "last_name"=>"Brguljan-Hitij", "scopus_author_id"=>"56032047000"}, {"first_name"=>"Teemu J.", "last_name"=>"Niiranen", "scopus_author_id"=>"12446050400"}, {"first_name"=>"Atsushi", "last_name"=>"Hozawa", "scopus_author_id"=>"7003868341"}, {"first_name"=>"José", "last_name"=>"Boggia", "scopus_author_id"=>"35274629700"}, {"first_name"=>"Lucas S.", "last_name"=>"Aparicio", "scopus_author_id"=>"23472257800"}, {"first_name"=>"Azusa", "last_name"=>"Hara", "scopus_author_id"=>"14070175300"}, {"first_name"=>"Jouni K.", "last_name"=>"Johansson", "scopus_author_id"=>"35329841400"}, {"first_name"=>"Takayoshi", "last_name"=>"Ohkubo", "scopus_author_id"=>"7201618716"}, {"first_name"=>"Christophe", "last_name"=>"Tzourio", "scopus_author_id"=>"7005447735"}, {"first_name"=>"George S.", "last_name"=>"Stergiou", "scopus_author_id"=>"57196263253"}, {"first_name"=>"Edgardo", "last_name"=>"Sandoya", "scopus_author_id"=>"55951608300"}, {"first_name"=>"Ichiro", "last_name"=>"Tsuji", "scopus_author_id"=>"7102034375"}, {"first_name"=>"Antti M.", "last_name"=>"Jula", "scopus_author_id"=>"6701433067"}, {"first_name"=>"Yutaka", "last_name"=>"Imai", "scopus_author_id"=>"36848420600"}, {"first_name"=>"Jan A.", "last_name"=>"Staessen", "scopus_author_id"=>"7202415416"}, {"first_name"=>"K.", "last_name"=>"Asayama", "scopus_author_id"=>"57198403247"}, {"first_name"=>"T.", "last_name"=>"Ohkubo", "scopus_author_id"=>"57196623585"}, {"first_name"=>"M.", "last_name"=>"Kikuya", "scopus_author_id"=>"7004682122"}, {"first_name"=>"R.", "last_name"=>"Inoue", "scopus_author_id"=>"8536911300"}, {"first_name"=>"M.", "last_name"=>"Satoh", "scopus_author_id"=>"36009558400"}, {"first_name"=>"M.", "last_name"=>"Hosaka", "scopus_author_id"=>"37026116300"}, {"first_name"=>"M. T.", "last_name"=>"Utsugi", "scopus_author_id"=>"24781498300"}, {"first_name"=>"T.", "last_name"=>"Hirose", "scopus_author_id"=>"11141476900"}, {"first_name"=>"A.", "last_name"=>"Hara", "scopus_author_id"=>"57197269523"}, {"first_name"=>"N.", "last_name"=>"Fukushima", "scopus_author_id"=>"42061350600"}, {"first_name"=>"T.", "last_name"=>"Obara", "scopus_author_id"=>"7103069231"}, {"first_name"=>"H.", "last_name"=>"Metoki", "scopus_author_id"=>"6701459599"}, {"first_name"=>"Y.", "last_name"=>"Imai", "scopus_author_id"=>"57198527617"}, {"first_name"=>"J.", "last_name"=>"Johansson", "scopus_author_id"=>"55414872600"}, {"first_name"=>"A.", "last_name"=>"Reunanen", "scopus_author_id"=>"7005479483"}, {"first_name"=>"A.", "last_name"=>"Jula", "scopus_author_id"=>"55800252500"}, {"first_name"=>"K.", "last_name"=>"Ohmori-Matsuda", "scopus_author_id"=>"57193980411"}, {"first_name"=>"S.", "last_name"=>"Kuriyama", "scopus_author_id"=>"7103378646"}, {"first_name"=>"M.", "last_name"=>"Kakizaki", "scopus_author_id"=>"7005258555"}, {"first_name"=>"A.", "last_name"=>"Hozawa", "scopus_author_id"=>"57200843629"}, {"first_name"=>"I.", "last_name"=>"Tsuji", "scopus_author_id"=>"57200881969"}, {"first_name"=>"T.", "last_name"=>"Mountokalakis", "scopus_author_id"=>"7003580487"}, {"first_name"=>"A.", "last_name"=>"Kollias", "scopus_author_id"=>"24722882200"}, {"first_name"=>"G.", "last_name"=>"Thomopoulou", "scopus_author_id"=>"22037055400"}, {"first_name"=>"P.", "last_name"=>"Kalogeropoulos", "scopus_author_id"=>"57194198045"}, {"first_name"=>"I.", "last_name"=>"Skeva", "scopus_author_id"=>"6602555408"}, {"first_name"=>"E.", "last_name"=>"Nasothimiou", "scopus_author_id"=>"57194282295"}, {"first_name"=>"N.", "last_name"=>"Pantazis", "scopus_author_id"=>"7004148119"}, {"first_name"=>"N.", "last_name"=>"Baibas", "scopus_author_id"=>"6603241962"}, {"first_name"=>"J.", "last_name"=>"Boggia", "scopus_author_id"=>"57190522169"}, {"first_name"=>"E.", "last_name"=>"Sandoya", "scopus_author_id"=>"6506397023"}, {"first_name"=>"J. A.", "last_name"=>"Staessen", "scopus_author_id"=>"56998894500"}, {"first_name"=>"L.", "last_name"=>"Thijs", "scopus_author_id"=>"35376331700"}, {"first_name"=>"N.", "last_name"=>"Cauwenberghs", "scopus_author_id"=>"56031187100"}, {"first_name"=>"Z.", "last_name"=>"Zhang", "scopus_author_id"=>"56032507100"}, {"first_name"=>"F.", "last_name"=>"Wei", "scopus_author_id"=>"52063978200"}, {"first_name"=>"J.", "last_name"=>"Knez", "scopus_author_id"=>"56031676100"}, {"first_name"=>"A.", "last_name"=>"Odili", "scopus_author_id"=>"6504220125"}, {"first_name"=>"Y.", "last_name"=>"Gu", "scopus_author_id"=>"55327488200"}, {"first_name"=>"Y.", "last_name"=>"Liu", "scopus_author_id"=>"26652219100"}, {"first_name"=>"Y.", "last_name"=>"Jin", "scopus_author_id"=>"57199283861"}, {"first_name"=>"L.", "last_name"=>"Jacobs", "scopus_author_id"=>"55387494500"}, {"first_name"=>"T.", "last_name"=>"Kuznetzova", "scopus_author_id"=>"56031385000"}], "year"=>2014, "source"=>"PLoS Medicine", "identifiers"=>{"pui"=>"372349016", "sgr"=>"84893754765", "issn"=>"15491676", "pmid"=>"24465187", "scopus"=>"2-s2.0-84893754765", "doi"=>"10.1371/journal.pmed.1001591", "isbn"=>"1549-1277"}, "id"=>"1eafbc80-7d09-33e7-92ab-5d080ba5e21f", "abstract"=>"BACKGROUND: The Global Burden of Diseases Study 2010 reported that hypertension is worldwide the leading risk factor for cardiovascular disease, causing 9.4 million deaths annually. We examined to what extent self-measurement of home blood pressure (HBP) refines risk stratification across increasing categories of conventional blood pressure (CBP).\\n\\nMETHODS AND FINDINGS: This meta-analysis included 5,008 individuals randomly recruited from five populations (56.6% women; mean age, 57.1 y). All were not treated with antihypertensive drugs. In multivariable analyses, hazard ratios (HRs) associated with 10-mm Hg increases in systolic HBP were computed across CBP categories, using the following systolic/diastolic CBP thresholds (in mm Hg): optimal, <120/<80; normal, 120-129/80-84; high-normal, 130-139/85-89; mild hypertension, 140-159/90-99; and severe hypertension, ≥160/≥100. Over 8.3 y, 522 participants died, and 414, 225, and 194 had cardiovascular, cardiac, and cerebrovascular events, respectively. In participants with optimal or normal CBP, HRs for a composite cardiovascular end point associated with a 10-mm Hg higher systolic HBP were 1.28 (1.01-1.62) and 1.22 (1.00-1.49), respectively. At high-normal CBP and in mild hypertension, the HRs were 1.24 (1.03-1.49) and 1.20 (1.06-1.37), respectively, for all cardiovascular events and 1.33 (1.07-1.65) and 1.30 (1.09-1.56), respectively, for stroke. In severe hypertension, the HRs were not significant (p≥0.20). Among people with optimal, normal, and high-normal CBP, 67 (5.0%), 187 (18.4%), and 315 (30.3%), respectively, had masked hypertension (HBP≥130 mm Hg systolic or ≥85 mm Hg diastolic). Compared to true optimal CBP, masked hypertension was associated with a 2.3-fold (1.5-3.5) higher cardiovascular risk. A limitation was few data from low- and middle-income countries.\\n\\nCONCLUSIONS: HBP substantially refines risk stratification at CBP levels assumed to carry no or only mildly increased risk, in particular in the presence of masked hypertension. Randomized trials could help determine the best use of CBP vs. HBP in guiding BP management. Our study identified a novel indication for HBP, which, in view of its low cost and the increased availability of electronic communication, might be globally applicable, even in remote areas or in low-resource settings.", "link"=>"http://www.mendeley.com/research/risk-stratification-selfmeasured-home-blood-pressure-across-categories-conventional-blood-pressure-p-1", "reader_count"=>61, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>5, "Librarian"=>1, "Researcher"=>8, "Student > Doctoral Student"=>4, "Student > Ph. D. 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Student"=>7, "Student > Postgraduate"=>2, "Student > Master"=>10, "Other"=>7, "Student > Bachelor"=>9, "Lecturer"=>2, "Lecturer > Senior Lecturer"=>1, "Professor"=>4}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Nursing and Health Professions"=>1, "Biochemistry, Genetics and Molecular Biology"=>2, "Medicine and Dentistry"=>42, "Agricultural and Biological Sciences"=>1, "Design"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Computer Science"=>3, "Immunology and Microbiology"=>2, "Economics, Econometrics and Finance"=>2}, "reader_count_by_subdiscipline"=>{"Design"=>{"Design"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>42}, "Immunology and Microbiology"=>{"Immunology and Microbiology"=>2}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>2}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>1}, "Computer Science"=>{"Computer Science"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>2}, "Unspecified"=>{"Unspecified"=>6}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}}, "reader_count_by_country"=>{"Argentina"=>1, "Japan"=>1, "Brazil"=>2, "United Kingdom"=>2, "Spain"=>2, "India"=>2}, "group_count"=>7}

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  • {"month"=>"8", "year"=>"2020", "pdf_views"=>"5", "xml_views"=>"0", "html_views"=>"6"}
  • {"month"=>"9", "year"=>"2020", "pdf_views"=>"11", "xml_views"=>"0", "html_views"=>"6"}
  • {"month"=>"10", "year"=>"2020", "pdf_views"=>"10", "xml_views"=>"0", "html_views"=>"7"}
  • {"month"=>"11", "year"=>"2020", "pdf_views"=>"23", "xml_views"=>"2", "html_views"=>"16"}
  • {"month"=>"12", "year"=>"2020", "pdf_views"=>"12", "xml_views"=>"1", "html_views"=>"7"}
  • {"month"=>"1", "year"=>"2021", "pdf_views"=>"26", "xml_views"=>"1", "html_views"=>"14"}
  • {"month"=>"2", "year"=>"2021", "pdf_views"=>"14", "xml_views"=>"2", "html_views"=>"8"}
  • {"month"=>"3", "year"=>"2021", "pdf_views"=>"5", "xml_views"=>"2", "html_views"=>"4"}

Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1352533"], "description"=>"<p>Electronic searches of the literature were performed in February 2012 before publication of the IDHOCO protocol <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001591#pmed.1001591-Niiranen1\" target=\"_blank\">[8]</a> and were repeated in July 2013.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "diagram", "studies"], "article_id"=>905043, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.g001", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_diagram_of_selected_studies_and_participants_/905043", "title"=>"Flow diagram of selected studies and participants.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352534"], "description"=>"<p>(A) indicates risk for total mortality, and (B–D) indicate risks for cardiovascular events, stroke, and cardiac events, respectively. CBP categories were optimal (<120/<80 mm Hg), normal (120–129/80–84 mm Hg), high-normal (130–139/85–89 mm Hg), mild hypertension (140–159/90–99 mm Hg), and severe hypertension (≥160/≥100 mm Hg). When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. The significance of the log-rank test for difference across the five categories was significant (<i>p</i><0.0001) for all of the end points.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "estimates", "categories"], "article_id"=>905044, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.g002", "stats"=>{"downloads"=>0, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Kaplan_Meier_survival_function_estimates_by_five_categories_of_conventional_blood_pressure_in_5_008_participants_/905044", "title"=>"Kaplan-Meier survival function estimates by five categories of conventional blood pressure in 5,008 participants.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352535"], "description"=>"<p>Rates (given as end points per 1,000 person-years) were standardized for sex and age by the direct method. CBP categories were optimal (<120/<80 mm Hg), normal (120–129/80–84 mm Hg), high-normal (130–139/85–89 mm Hg), mild hypertension (140–159/90–99 mm Hg), and severe hypertension (≥160/≥100 mm Hg). When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. The number of end points contributing to the rates is presented. The <i>p</i>-values refer to the significance for linear trend across the five categories of CBP. HT, hypertension.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "rates", "categories"], "article_id"=>905045, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.g003", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Incidence_rates_in_5_008_participants_by_increasing_categories_of_conventional_blood_pressure_/905045", "title"=>"Incidence rates in 5,008 participants by increasing categories of conventional blood pressure.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352536"], "description"=>"<p>Participants with optimal blood pressure without elevated HBP were the reference group. The categories of CBP were optimal (<120/<80 mm Hg), normal (120–129/80–84 mm Hg), and high-normal (130–139/85–89 mm Hg). When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. Systolic/diastolic thresholds for hypertension on home measurement were ≥130/≥85 mm Hg. The HRs were adjusted for cohort as random effect and for sex, age, body mass index, smoking, total cholesterol, diabetes mellitus, and history of cardiovascular disease as fixed effects. Horizontal lines denote the 95% confidence interval. The diamond represents the pooled estimate in all participants with masked hypertension (MHT). The <i>p</i>-value for heterogeneity was derived by testing an ordinal variable in Cox proportional hazards regression coding for the three subgroups among participants with masked hypertension.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "ratios", "masked", "mm", "high-normal"], "article_id"=>905046, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.g004", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Hazard_ratios_associated_with_masked_hypertension_8805_130_8805_85_mm_Hg_in_participants_with_optimal_normal_and_high_normal_conventional_blood_pressure_/905046", "title"=>"Hazard ratios associated with masked hypertension (≥130/≥85 mm Hg) in participants with optimal, normal, and high-normal conventional blood pressure.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352538"], "description"=>"<p>Participants with optimal blood pressure without elevated HBP were the reference group. CBP categories were optimal (<120/<80 mm Hg), normal (120–129/80–84 mm Hg), and high-normal (130–139/85–89 mm Hg). When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. Systolic/diastolic thresholds for hypertension on home measurement were ≥135/≥85 mm Hg. The HRs were adjusted for cohort as a random effect and for sex, age, body mass index, smoking, total cholesterol, diabetes mellitus, and history of cardiovascular disease as fixed effects. Horizontal lines denote the 95% confidence interval. The diamond represents the pooled estimate in all participants with masked hypertension (MHT). The <i>p</i>-value for heterogeneity was derived by testing an ordinal variable in Cox proportional hazards regression coding for the three subgroups among participants with masked hypertension.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "ratios", "masked", "mm", "high-normal"], "article_id"=>905048, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.g005", "stats"=>{"downloads"=>1, "page_views"=>18, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Hazard_ratios_associated_with_masked_hypertension_8805_135_8805_85_mm_Hg_in_participants_with_optimal_normal_and_high_normal_conventional_blood_pressure_/905048", "title"=>"Hazard ratios associated with masked hypertension (≥135/≥85 mm Hg) in participants with optimal, normal, and high-normal conventional blood pressure.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352539"], "description"=>"<p>Systolic/diastolic thresholds for CBP were as follows: optimal, <120/<80 mm Hg; normal, 120–129/80–84 mm Hg; and high-normal, 130–139/85–89 mm Hg. When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. Significance of the difference from the adjacent lower category of CBP: *<i>p</i><0.05; †<i>p</i><0.001; and ‡<i>p</i><0.0001.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "masked", "mm", "compared", "high-normal"], "article_id"=>905049, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t010", "stats"=>{"downloads"=>5, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_participants_with_masked_hypertension_home_blood_pressure_8805_135_8805_85_mm_Hg_compared_with_participants_with_true_optimal_normal_or_high_normal_blood_pressure_home_blood_pressure_lt_135_lt_85_mm_Hg_/905049", "title"=>"Characteristics of participants with masked hypertension (home blood pressure ≥135/≥85 mm Hg) compared with participants with true optimal, normal, or high-normal blood pressure (home blood pressure <135/<85 mm Hg).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352540"], "description"=>"<p>Systolic/diastolic thresholds for CBP were as follows: optimal, <120/<80 mm Hg; normal, 120–129/80–84 mm Hg; and high-normal, 130–139/85–89 mm Hg. When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. Significance of the difference from the adjacent lower category of CBP: *<i>p</i><0.05; †<i>p</i><0.01; ‡<i>p</i><0.001; and §<i>p</i><0.0001.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "masked", "mm", "compared", "high-normal"], "article_id"=>905050, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t009", "stats"=>{"downloads"=>4, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_participants_with_masked_hypertension_home_blood_pressure_8805_130_8805_85_mm_Hg_compared_with_participants_with_true_optimal_normal_or_high_normal_blood_pressure_home_blood_pressure_lt_130_lt_85_mm_Hg_/905050", "title"=>"Characteristics of participants with masked hypertension (home blood pressure ≥130/≥85 mm Hg) compared with participants with true optimal, normal, or high-normal blood pressure (home blood pressure <130/<85 mm Hg).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352541"], "description"=>"<p>E/R indicates the number of end points/participants at risk. White (race) included Finns, Greeks, and Uruguayans. Systolic/diastolic thresholds for CBP were as follows: optimal, <120/<80 mm Hg; normal, 120–129/80–84 mm Hg; high-normal, 130–139/85–89 mm Hg; mild hypertension, 140–159/90–99 mm Hg; and severe hypertension, ≥160/≥100 mm Hg. When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. HRs reflect the risk for a 10-mm Hg increase in home systolic pressure and were adjusted for cohort as a random effect and for sex, age, body mass index, smoking, total cholesterol, diabetes mellitus, and history of cardiovascular disease as fixed effects. Significance of the HRs: *<i>p</i><0.05; †<i>p</i><0.01; and ‡<i>p</i><0.001.</p><p>§indicates a significant difference (<i>p</i>≤0.05) in the HRs between corresponding strata.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "anthropometric"], "article_id"=>905051, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t008", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sensitivity_analysis_for_total_mortality_and_cardiovascular_events_according_to_anthropometric_characteristics_and_cardiovascular_risk_factors_/905051", "title"=>"Sensitivity analysis for total mortality and cardiovascular events according to anthropometric characteristics and cardiovascular risk factors.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352542"], "description"=>"<p>Systolic/diastolic thresholds for CBP were as follows: optimal, <120/<80 mm Hg; normal, 120–129/80–84 mm Hg; high-normal, 130–139/85–89 mm Hg; mild hypertension, 140–159/90–99 mm Hg; and severe hypertension, ≥160/≥100 mm Hg. When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. The category prehypertension includes participants with normal and high-normal blood pressure, and the category hypertension includes participants with mild and severe hypertension. The number of people at risk and the number of events are given in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001591#pmed-1001591-t003\" target=\"_blank\">Tables 3</a> and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001591#pmed-1001591-t004\" target=\"_blank\">4</a>, respectively. HRs reflect the risk associated with a 10-mm Hg increase in home systolic pressure. HRs were adjusted for cohort as a random effect and for sex, age, body mass index, smoking, total cholesterol, diabetes mellitus, and history of cardiovascular disease as fixed effects. Significance of the HRs: *<i>p</i><0.05 and †<i>p</i><0.01.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "ratios", "systolic"], "article_id"=>905052, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t005", "stats"=>{"downloads"=>5, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Standardized_hazard_ratios_associated_with_systolic_home_blood_pressure_by_category_of_conventional_blood_pressure_/905052", "title"=>"Standardized hazard ratios associated with systolic home blood pressure by category of conventional blood pressure.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352544"], "description"=>"<p>Number and HR indicate the number of end points (percentage rate) and HR (95% confidence interval), respectively. Systolic/diastolic thresholds for CBP were as follows: optimal, <120/<80 mm Hg; normal, 120–129/80–84 mm Hg; high-normal, 130–139/85–89 mm Hg; mild hypertension, 140–159/90–99 mm Hg; and severe hypertension, ≥160/≥100 mm Hg. When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. HRs express the risk compared with optimal blood pressure (reference). HRs were adjusted for cohort as a random effect and for sex, age, body mass index, smoking, total cholesterol, diabetes mellitus, and history of cardiovascular disease as fixed effects. The <i>p</i>-value refers to linear trend across the blood pressure categories. Significance of the HRs: *<i>p</i><0.01; †<i>p</i><0.001; and ‡<i>p</i><0.0001.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "categories"], "article_id"=>905053, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t004", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risks_associated_with_increasing_categories_of_conventional_blood_pressure_/905053", "title"=>"Risks associated with increasing categories of conventional blood pressure.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352545"], "description"=>"<p>E/R indicates the number of cardiovascular events/participants at risk. Systolic/diastolic thresholds for CBP were as follows: optimal, <120/<80 mm Hg; normal, 120–129/80–84 mm Hg; high-normal, 130–139/85–89 mm Hg; mild hypertension, 140–159/90–99 mm Hg; and severe hypertension, ≥160/≥100 mm Hg. When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. HRs reflect the risk for a 10-mm Hg increase in home systolic pressure and were adjusted for cohort as a random effect and for sex, age, body mass index, smoking, total cholesterol, diabetes mellitus, and history of cardiovascular disease as fixed effects. Significance of the HRs: *<i>p</i><0.05 and †<i>p</i><0.01.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "cohort"], "article_id"=>905055, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t007", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sensitivity_analysis_for_total_mortality_and_cardiovascular_events_with_one_cohort_excluded_/905055", "title"=>"Sensitivity analysis for total mortality and cardiovascular events with one cohort excluded.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352547"], "description"=>"<p>Systolic/diastolic thresholds for CBP were as follows: optimal, <120/<80 mm Hg; normal, 120–129/80–84 mm Hg; high-normal, 130–139/85–89 mm Hg; mild hypertension, 140–159/90–99 mm Hg; and severe hypertension, ≥160/≥100 mm Hg. When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. The category prehypertension includes participants with normal and high-normal blood pressure, and the category hypertension includes participants with mild and severe hypertension. The number of people at risk and the number of events are given in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001591#pmed-1001591-t003\" target=\"_blank\">Tables 3</a> and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001591#pmed-1001591-t004\" target=\"_blank\">4</a>, respectively. HRs reflect the risk associated with a 5-mm Hg increase in home diastolic pressure. HRs were adjusted for cohort as a random effect and for sex, age, body mass index, smoking, total cholesterol, diabetes mellitus, and history of cardiovascular disease as fixed effects. Significance of the HRs: *<i>p</i><0.05; †<i>p</i><0.01; and ‡<i>p</i><0.001.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "ratios", "diastolic"], "article_id"=>905057, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t006", "stats"=>{"downloads"=>1, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Standardized_hazard_ratios_associated_with_diastolic_home_blood_pressure_by_category_of_conventional_blood_pressure_/905057", "title"=>"Standardized hazard ratios associated with diastolic home blood pressure by category of conventional blood pressure.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352548"], "description"=>"<p>BP indicates blood pressure.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "european", "american", "guidelines"], "article_id"=>905058, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t001", "stats"=>{"downloads"=>1, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Classification_of_conventional_blood_pressure_according_to_European_and_American_guidelines_and_the_current_study_/905058", "title"=>"Classification of conventional blood pressure according to European and American guidelines and the current study.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352549"], "description"=>"<p>White (race) included Finns, Greeks and Uruguayans. Systolic/diastolic thresholds for CBP were as follows: optimal, <120/<80 mm Hg; normal, 120–129/80–84 mm Hg; high-normal, 130–139/85–89 mm Hg; mild hypertension, 140–159/90–99 mm Hg; and severe hypertension, ≥160/≥100 mm Hg. When the systolic and diastolic blood pressures were in different categories, the participant was assigned to the higher category. All of the ANOVA and χ<sup>2</sup> statistic <i>p</i>-values for differences across the five categories were significant (<i>p</i>≤0.015) except for the prevalence of smoking (<i>p</i> = 0.083). Significance of the difference with the adjacent lower category of CBP: *<i>p</i><0.05; †<i>p</i><0.001; and ‡<i>p</i><0.0001.</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology"], "article_id"=>905059, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t003", "stats"=>{"downloads"=>5, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Participants_characteristics_according_to_conventional_blood_pressure_categories_/905059", "title"=>"Participants characteristics according to conventional blood pressure categories.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352550"], "description"=>"a<p>Median (5th to 95th percentile interval).</p>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "sampling", "methods", "idhoco"], "article_id"=>905060, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591.t002", "stats"=>{"downloads"=>0, "page_views"=>8, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Population_sampling_methods_in_IDHOCO_cohorts_/905060", "title"=>"Population sampling methods in IDHOCO cohorts.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}
  • {"files"=>["https://ndownloader.figshare.com/files/1352551"], "description"=>"<div><p>Background</p><p>The Global Burden of Diseases Study 2010 reported that hypertension is worldwide the leading risk factor for cardiovascular disease, causing 9.4 million deaths annually. We examined to what extent self-measurement of home blood pressure (HBP) refines risk stratification across increasing categories of conventional blood pressure (CBP).</p><p>Methods and Findings</p><p>This meta-analysis included 5,008 individuals randomly recruited from five populations (56.6% women; mean age, 57.1 y). All were not treated with antihypertensive drugs. In multivariable analyses, hazard ratios (HRs) associated with 10-mm Hg increases in systolic HBP were computed across CBP categories, using the following systolic/diastolic CBP thresholds (in mm Hg): optimal, <120/<80; normal, 120–129/80–84; high-normal, 130–139/85–89; mild hypertension, 140–159/90–99; and severe hypertension, ≥160/≥100.</p><p>Over 8.3 y, 522 participants died, and 414, 225, and 194 had cardiovascular, cardiac, and cerebrovascular events, respectively. In participants with optimal or normal CBP, HRs for a composite cardiovascular end point associated with a 10-mm Hg higher systolic HBP were 1.28 (1.01–1.62) and 1.22 (1.00–1.49), respectively. At high-normal CBP and in mild hypertension, the HRs were 1.24 (1.03–1.49) and 1.20 (1.06–1.37), respectively, for all cardiovascular events and 1.33 (1.07–1.65) and 1.30 (1.09–1.56), respectively, for stroke. In severe hypertension, the HRs were not significant (<i>p</i>≥0.20). Among people with optimal, normal, and high-normal CBP, 67 (5.0%), 187 (18.4%), and 315 (30.3%), respectively, had masked hypertension (HBP≥130 mm Hg systolic or ≥85 mm Hg diastolic). Compared to true optimal CBP, masked hypertension was associated with a 2.3-fold (1.5–3.5) higher cardiovascular risk. A limitation was few data from low- and middle-income countries.</p><p>Conclusions</p><p>HBP substantially refines risk stratification at CBP levels assumed to carry no or only mildly increased risk, in particular in the presence of masked hypertension. Randomized trials could help determine the best use of CBP vs. HBP in guiding BP management. Our study identified a novel indication for HBP, which, in view of its low cost and the increased availability of electronic communication, might be globally applicable, even in remote areas or in low-resource settings.</p><p><i>Please see later in the article for the Editors' Summary</i></p></div>", "links"=>[], "tags"=>["cardiovascular", "hypertension", "epidemiology", "Cardiovascular disease epidemiology", "stratification", "self-measured", "categories", "participant-level"], "article_id"=>905061, "categories"=>["Medicine"], "users"=>["Kei Asayama", "Lutgarde Thijs", "Jana Brguljan-Hitij", "Teemu J. Niiranen", "Atsushi Hozawa", "José Boggia", "Lucas S. Aparicio", "Azusa Hara", "Jouni K. Johansson", "Takayoshi Ohkubo", "Christophe Tzourio", "George S. Stergiou", "Edgardo Sandoya", "Ichiro Tsuji", "Antti M. Jula", "Yutaka Imai", "Jan A. Staessen"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001591", "stats"=>{"downloads"=>1, "page_views"=>17, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Risk_Stratification_by_Self_Measured_Home_Blood_Pressure_across_Categories_of_Conventional_Blood_Pressure_A_Participant_Level_Meta_Analysis_/905061", "title"=>"Risk Stratification by Self-Measured Home Blood Pressure across Categories of Conventional Blood Pressure: A Participant-Level Meta-Analysis", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-01-21 02:47:52"}

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