Ambulatory and home blood pressure monitoring for cardiovascular disease risk evaluation: a systematic review and meta-analysis of prospective cohort studies

J Hypertens. 2024 Jan 1;42(1):1-9. doi: 10.1097/HJH.0000000000003557. Epub 2023 Sep 13.

Abstract

Objective: The aim of this work was to systematically review the level of evidence based on prospective cohort studies investigating the role of 24-h ambulatory blood pressure measurement (ABPM) and home blood pressure measurement (HBPM) on cardiovascular disease (CVD) risk prediction.

Methods: Eight studies were included in the meta-analysis. The Der Simonian and Laird's random-effects model with standard error adjustment using the Knapp-Hartung method was used.

Results: SBP from ABPM and HBPM was significantly and positively associated with CVD risk [ combined hazard ratio per 1-SD SBP, 95% confidence interval (95% CI): 1.32, 1.19-1.45, I2 = 35.8%, and 1.30, 95% CI: 1.11-1.49, I2 = 79.1%, respectively], after adjusting for office BP levels and other potential confounders. DBP from both ABPM and HBPM was positively associated with CVD risk ( combined hazard ratio per 1-SD DBP, 95% CI: 1.15, 1.01-1.29, I2 = 73.1% and 1.21, 1.05-1.37, I2 = 84.5%, respectively).

Conclusion: BP either from ABPM or HBPM could predict CVD risk. As so, at least one of out-of-office BP measurements have to be taken into account during the evaluation of the hypertensive population.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Blood Pressure / physiology
  • Blood Pressure Monitoring, Ambulatory / methods
  • Cardiovascular Diseases* / complications
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Humans
  • Hypertension*
  • Prospective Studies