HypertensionMeta-analysis
Ambulatory blood pressure monitoring, European guideline targets, and cardiovascular outcomes: an individual patient data meta-analysis
- Individual patient data meta-analysis of population cohorts
- person-level meta-analysis
Authors' conclusion
Longer time that ABP is within the 2024 ESC target range is associated with reduced adverse outcomes; PTTR derived from ABP refines risk prediction and compared with office BP avoids misclassification of individuals with regard to BP control.
Study context
- Population
- Individuals enrolled in 14 population cohorts with ambulatory blood pressure (BP) monitoring
- Participants
- 14,230 individuals · 14 population cohorts
- Comparison
- Percentage of time ambulatory blood pressure (ABP) within 2024 European Society of Cardiology (ESC) target range, by quartile
- Outcome
- Mortality and CV endpoints by 24-h PTTR (non-elevated ABP <115/65 mmHg)
- Follow-up
- Median 10.9 years
Pooled result
As reported in the abstract
Mortality and CV endpoints by 24-h PTTR
24-h PTTR (standardized)Hazard ratio (95% CI)
mortality; multivariable-adjusted
0.57(0.46–0.71)
CV endpoints; multivariable-adjusted
0.30(0.23–0.39)
- Deaths (N = 3117) across increasing 24-h PTTR quartiles, per 1000 person-years
- 21.3 to 16.1
- CV endpoints (N = 2265) across increasing 24-h PTTR quartiles, per 1000 person-years
- 20.3 to 11.3
Further pooled results
24-h PTTR distribution
- Median 24-h PTTR (IQR 5-33)
- 18%
- Corresponding hours (1.2-7.9)
- 4.3 h
Daytime and nighttime ABP, CV mortality, coronary endpoints, stroke, subgroups
- Confirmatory results
2024 ESC vs 2018 ESC/ESH 24-h PTTR: interval required to reduce relative risk
- Shortened from 60% to 18%
- 14.4-4.3 h
Office BP vs 24-h PTTR
- Office BP misclassified most participants with regard to BP control
Original publication
Ambulatory blood pressure monitoring, European guideline targets, and cardiovascular outcomes: an individual patient data meta-analysis. Eur Heart J. Published 18 April 2025. doi:10.1093/eurheartj/ehaf220
Summarised from the published abstract; every number is checked against it