Investigation on Cardiovascular Risk Prediction Using Physiological Parameters

Table 1

Sample of cohort studies reporting the independent predictive values of blood pressure.

Markers	Population (no.)	Age at entry (y)	Followup (y)	Covariates	End events (no.)	Model based	Prognostic values	Discrimination,; calibration, and reclassification	Reference
SBP	General Japanese man (48224)	40–89	8.4	Age, BMI, serum total cholesterol, and smoking	Stroke (1231) and MI events (220)	Poisson regression model	For stroke, HR = 1.51; For MI, HR = 1.23	NR	[33]
DBP							For stroke, HR = 1.53; For MI, HR = 1.17
MBP							For stroke, HR = 1.60; For MI, HR = 1.22
PP							For stroke, HR = 1.27; For MI, HR = 1.17
Visit-to-visit variability (SD) in SBP	Patients with prev. transient ischaemic attack (1324)	60.3 (mean)	2	Age, sex, mean SBP, and other risk factors	Stroke (270), coronary event (166)	Cox model	For stroke, HR = 6.22	NR	[34]
Maximum SBP reached							For stroke, HR=15.01
Episodic severe hypertension							For stroke, HR = 3.58
Residual visit-to-visit variability (SD)	Patients with treated hypertension (2011)	40–79	5.5	NR	Stroke and coronary event	Cox model	For stroke, HR = 3.25	NR	[34]
Variability (CoV of daytime SBP) in ABPM							For vascular events, HR = 1.42
Clinic SBP;	Subjects fulfilling series of exclusion and inclusion criteria (3344)	52.6±14.5	5.6	Age, sex, and diabetes	Total CVD events (331)	Cox model	HR = 1.35	NR	[35]
Awake SBP mean;							HR = 1.35
Asleep SBP mean;							HR = 1.52
48-h SBP mean;							HR = 1.43
Sleep-time relative decline;							HR = 0.72
SD of awake SBP;							HR = 1.29
SD of asleep SBP;							HR = 1.22
SD of 48-h SBP							HR = 1.24
Morning surge SBP							HR = 0.79
24-h DBP SD;	Subjects referred for assessment of their hypertension (10499)	54.5 (mean)	5.8	Age, sex, and BMI, smoking, prev. CVD, 24-h BP, and 24-h DBP	CV death	Cox model	HR = 1.04	NR	[36]
24-h wDBP SD;							HR = 1.06
DBP ARV;							HR = 1.06
Daytime SBP	Untreated hypertension patients (5292)	16.2–92.4	8.4	Age, sex, BMI, smoking, diabetes, prev. CVD events, and clinic SBP	All-cause mortality (646)	Cox model	HR = 1.07	NR	[24]
Nighttime SBP							HR = 1.15
24-h SBP							HR = 1.13
Daytime systolic BP variability; > 18.8	General Japanese subjects (1542)	≥40	8.5	Age, sex, smoking, diabetes, use of antihypertensive medication, obesity, prev. hyperlipidemia, CVD, 24-h SBP, DBP, and heart rate	CV mortality (67)	Cox model	RR = 2.69	NR	[23]
Daytime heart rate variability; < 7.2							RR = 4.45
Bruce stage 2 DBP	Framingham	20–69	20	Age, sex	CVD events (240)	Cox model	HR = 1.41;	NR	[25]
Bruce stage 2 SBP	Study						HR = 0.97
Recovery DBP after exercise; (3rd min)	Subjects (3045)						HR = 1.53
Bruce stage 2 SBP > 180 mmHg (versus SBP ≤ 180 mmHg)	Asymptomatic patients (6578)	30–70	20	Age, sex, diabetes, LDL and HDL cholesterol, triglycerides, smoking, BMI, and family history	CVD death (385)	Cox model	HR = 1.96	Net reclassification improvement, SBP, 12%; DBP, 9.9%	[37]
Bruce stage 2 DBP > 90 mmHg (versus DBP ≤ 90 mmHg)							HR = 1.48

BMI indicates body mass index; CoV: coefficient of variation; wDBP SD: weighted mean of daytime and nighttime DBP SD; ARV: average real variability; NR: not report; prev.: previous; LDL: low-density lipoprotein; HDL: high-density lipoprotein; CV: cardiovascular.