Mean arterial pressure is better at predicting future metabolic syndrome in the normotensive elderly: A prospective cohort study in Taiwan

Chun Hsien Hsu, Jin Biou Chang, I. Chao Liu, Shu Chuen Lau, Shu Man Yu, Chang Hsun Hsieh, Jiunn Diann Lin, Yao Jen Liang, Dee Pei, Yen Lin Chen

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To compare four different blood pressure (BP) measurements-systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP)-in predicting future metabolic syndrome (MetS) among the normotensive elderly population, and to estimate the optimal cutoff value of the best single measurement for clinical practice. Methods: A total of 2782 non-medicated participants aged ≥ 60. years were enrolled in a standard health examination program in Taiwan from January 2004 to December 2013. Two thirds of the participants were randomly designated as the training group (n = 1855) and the other one third as the validation group (n = 927). The mean follow-up time was 3.60. years for both the training and validation groups. MAP and PP were calculated from SBP and DBP. Results: SBP, DBP, and MAP were associated with future MetS, whereas PP was not. MAP had the largest hazard ratio in Cox regression (men 1.342 [95% CI 1.158-1.555] and women 1.348 [95% CI 1.185-1.534] in the training group; men 1.640 [95% CI 1.317-2.041] and women 1.485 [95% CI 1.230-1.794] in the validation group) and the largest area under the receiver operating characteristic curve (men 0.598 ± 0.021 and women 0.602 ± 0.021 in the training group). Multivariable Cox regression further indicated that a higher MAP level was independently associated with the future occurrence of MetS. Participants with MAP above the cutoff value (84.0. mm Hg for men, 83.3. mm Hg for women) had a higher cumulative incidence of MetS than did their counterparts after four years' follow-up in both the training and validation groups. The results derived from the training data could be replicated in the validation data, indicating that the results were generalizable across distinct samples. Conclusions: MAP is more accurate than SBP, DBP, and PP in predicting future MetS among the normotensive geriatric population. Calculation of MAP is recommended when dealing with normotensive patients aged ≥ 60. years in clinical practice.

Original languageEnglish
Pages (from-to)76-82
Number of pages7
JournalPreventive Medicine
Volume72
DOIs
Publication statusPublished - Mar 1 2015

Fingerprint

Taiwan
Arterial Pressure
Cohort Studies
Prospective Studies
Blood Pressure
ROC Curve
Geriatrics
Population
Incidence
Health

Keywords

  • Elderly
  • Mean arterial pressure
  • Metabolic syndrome
  • Preventive geriatrics
  • Primary prevention

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology
  • Medicine(all)

Cite this

Mean arterial pressure is better at predicting future metabolic syndrome in the normotensive elderly : A prospective cohort study in Taiwan. / Hsu, Chun Hsien; Chang, Jin Biou; Liu, I. Chao; Lau, Shu Chuen; Yu, Shu Man; Hsieh, Chang Hsun; Lin, Jiunn Diann; Liang, Yao Jen; Pei, Dee; Chen, Yen Lin.

In: Preventive Medicine, Vol. 72, 01.03.2015, p. 76-82.

Research output: Contribution to journalArticle

Hsu, Chun Hsien ; Chang, Jin Biou ; Liu, I. Chao ; Lau, Shu Chuen ; Yu, Shu Man ; Hsieh, Chang Hsun ; Lin, Jiunn Diann ; Liang, Yao Jen ; Pei, Dee ; Chen, Yen Lin. / Mean arterial pressure is better at predicting future metabolic syndrome in the normotensive elderly : A prospective cohort study in Taiwan. In: Preventive Medicine. 2015 ; Vol. 72. pp. 76-82.
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abstract = "Objective: To compare four different blood pressure (BP) measurements-systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP)-in predicting future metabolic syndrome (MetS) among the normotensive elderly population, and to estimate the optimal cutoff value of the best single measurement for clinical practice. Methods: A total of 2782 non-medicated participants aged ≥ 60. years were enrolled in a standard health examination program in Taiwan from January 2004 to December 2013. Two thirds of the participants were randomly designated as the training group (n = 1855) and the other one third as the validation group (n = 927). The mean follow-up time was 3.60. years for both the training and validation groups. MAP and PP were calculated from SBP and DBP. Results: SBP, DBP, and MAP were associated with future MetS, whereas PP was not. MAP had the largest hazard ratio in Cox regression (men 1.342 [95{\%} CI 1.158-1.555] and women 1.348 [95{\%} CI 1.185-1.534] in the training group; men 1.640 [95{\%} CI 1.317-2.041] and women 1.485 [95{\%} CI 1.230-1.794] in the validation group) and the largest area under the receiver operating characteristic curve (men 0.598 ± 0.021 and women 0.602 ± 0.021 in the training group). Multivariable Cox regression further indicated that a higher MAP level was independently associated with the future occurrence of MetS. Participants with MAP above the cutoff value (84.0. mm Hg for men, 83.3. mm Hg for women) had a higher cumulative incidence of MetS than did their counterparts after four years' follow-up in both the training and validation groups. The results derived from the training data could be replicated in the validation data, indicating that the results were generalizable across distinct samples. Conclusions: MAP is more accurate than SBP, DBP, and PP in predicting future MetS among the normotensive geriatric population. Calculation of MAP is recommended when dealing with normotensive patients aged ≥ 60. years in clinical practice.",
keywords = "Elderly, Mean arterial pressure, Metabolic syndrome, Preventive geriatrics, Primary prevention",
author = "Hsu, {Chun Hsien} and Chang, {Jin Biou} and Liu, {I. Chao} and Lau, {Shu Chuen} and Yu, {Shu Man} and Hsieh, {Chang Hsun} and Lin, {Jiunn Diann} and Liang, {Yao Jen} and Dee Pei and Chen, {Yen Lin}",
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T1 - Mean arterial pressure is better at predicting future metabolic syndrome in the normotensive elderly

T2 - A prospective cohort study in Taiwan

AU - Hsu, Chun Hsien

AU - Chang, Jin Biou

AU - Liu, I. Chao

AU - Lau, Shu Chuen

AU - Yu, Shu Man

AU - Hsieh, Chang Hsun

AU - Lin, Jiunn Diann

AU - Liang, Yao Jen

AU - Pei, Dee

AU - Chen, Yen Lin

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Objective: To compare four different blood pressure (BP) measurements-systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP)-in predicting future metabolic syndrome (MetS) among the normotensive elderly population, and to estimate the optimal cutoff value of the best single measurement for clinical practice. Methods: A total of 2782 non-medicated participants aged ≥ 60. years were enrolled in a standard health examination program in Taiwan from January 2004 to December 2013. Two thirds of the participants were randomly designated as the training group (n = 1855) and the other one third as the validation group (n = 927). The mean follow-up time was 3.60. years for both the training and validation groups. MAP and PP were calculated from SBP and DBP. Results: SBP, DBP, and MAP were associated with future MetS, whereas PP was not. MAP had the largest hazard ratio in Cox regression (men 1.342 [95% CI 1.158-1.555] and women 1.348 [95% CI 1.185-1.534] in the training group; men 1.640 [95% CI 1.317-2.041] and women 1.485 [95% CI 1.230-1.794] in the validation group) and the largest area under the receiver operating characteristic curve (men 0.598 ± 0.021 and women 0.602 ± 0.021 in the training group). Multivariable Cox regression further indicated that a higher MAP level was independently associated with the future occurrence of MetS. Participants with MAP above the cutoff value (84.0. mm Hg for men, 83.3. mm Hg for women) had a higher cumulative incidence of MetS than did their counterparts after four years' follow-up in both the training and validation groups. The results derived from the training data could be replicated in the validation data, indicating that the results were generalizable across distinct samples. Conclusions: MAP is more accurate than SBP, DBP, and PP in predicting future MetS among the normotensive geriatric population. Calculation of MAP is recommended when dealing with normotensive patients aged ≥ 60. years in clinical practice.

AB - Objective: To compare four different blood pressure (BP) measurements-systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP)-in predicting future metabolic syndrome (MetS) among the normotensive elderly population, and to estimate the optimal cutoff value of the best single measurement for clinical practice. Methods: A total of 2782 non-medicated participants aged ≥ 60. years were enrolled in a standard health examination program in Taiwan from January 2004 to December 2013. Two thirds of the participants were randomly designated as the training group (n = 1855) and the other one third as the validation group (n = 927). The mean follow-up time was 3.60. years for both the training and validation groups. MAP and PP were calculated from SBP and DBP. Results: SBP, DBP, and MAP were associated with future MetS, whereas PP was not. MAP had the largest hazard ratio in Cox regression (men 1.342 [95% CI 1.158-1.555] and women 1.348 [95% CI 1.185-1.534] in the training group; men 1.640 [95% CI 1.317-2.041] and women 1.485 [95% CI 1.230-1.794] in the validation group) and the largest area under the receiver operating characteristic curve (men 0.598 ± 0.021 and women 0.602 ± 0.021 in the training group). Multivariable Cox regression further indicated that a higher MAP level was independently associated with the future occurrence of MetS. Participants with MAP above the cutoff value (84.0. mm Hg for men, 83.3. mm Hg for women) had a higher cumulative incidence of MetS than did their counterparts after four years' follow-up in both the training and validation groups. The results derived from the training data could be replicated in the validation data, indicating that the results were generalizable across distinct samples. Conclusions: MAP is more accurate than SBP, DBP, and PP in predicting future MetS among the normotensive geriatric population. Calculation of MAP is recommended when dealing with normotensive patients aged ≥ 60. years in clinical practice.

KW - Elderly

KW - Mean arterial pressure

KW - Metabolic syndrome

KW - Preventive geriatrics

KW - Primary prevention

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