Interplay of age and sex with clinic and ambulatory blood pressure and mortality

Boehm, M; De la Sierra, A; Schwantke, I; Haring, B; Vinyoles, E; Gorostidi, M; Segura, J; Williams, B; Staplin, N; Tokcan, M; Mahfoud, F; Lauder, L; Fleig, S; Schneider, C; Ruilope, L

Journal article

Interplay of age and sex with clinic and ambulatory blood pressure and mortality

Abstract:: BACKGROUND: To explore associations of clinic and 24-hour ambulatory blood pressure monitoring (ABPM) with cardiovascular death (CVD), parameters were modeled for age and sex in this large cohort in primary care.

METHODS: In the Spanish ABPM Registry 59.124 patients had complete data on mortality, age, sex and all ABPM. Office, mean, 24-hour, daytime and nighttime systolic (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) were related to CVD according to age and sex and were modelled with restricted cubic splines to get trajectories. During a median of 9.7 years, 2361 patients had CVD (1229 males, 1132 females).

RESULTS: Non-linear relationships for office, 24-hour mean, daytime and nighttime SBP, DBP and PP (p<0.0001 for all) for both sexes were observed. Until 75 years, SBP was higher in males than females but differences were minimized after approximately 60-70 years (p for interaction <0.0001). High SBP and PP associated with CVD without heterogeneity between sexes and across ageing. The increase and level of SBP and PP was higher at a higher age in females than males (p for interaction <0.0001). CVD was age-dependent and ABPM, in particular nighttime BP did more closely associate with risk than office BP in younger than in older individuals.

CONCLUSIONS: 24-hour mean, nighttime blood pressure and PP were closely associated with risk being stronger in elderly females than males after 75 years corresponding to a rise in BP in older females. Guidelines should continue to mandate evaluation 24-hour ABPM data for risk prediction.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Boehm, M., De la Sierra, A., Schwantke, I., Haring, B., Vinyoles, E., Gorostidi, M., Segura, J., Williams, B., Staplin, N., Tokcan, M., Mahfoud, F., Lauder, L., Fleig, S., Schneider, C., & Ruilope, L. (2026). Interplay of age and sex with clinic and ambulatory blood pressure and mortality. Hypertension.

MLA Style

Boehm, M, et al. “Interplay of Age and Sex with Clinic and Ambulatory Blood Pressure and Mortality.” Hypertension, 2026.

Chicago Style

Boehm, M, A De la Sierra, I Schwantke, et al. 2026. “Interplay of Age and Sex with Clinic and Ambulatory Blood Pressure and Mortality.” Hypertension.
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