Ambulatory blood pressure monitoring and its association with adverse health outcomes. Evidence from a population-based study
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Oulu University Hospital, Auditorium 3
Topic of the dissertation
Ambulatory blood pressure monitoring and its association with adverse health outcomes. Evidence from a population-based study
Doctoral candidate
Licentiate of Medicine Päivi Lempiäinen
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Biomedicine and Internal Medicine
Subject of study
Internal medicine
Opponent
Professor Risto Tertti, University of Turku and Vaasa Central Hospital
Custos
Professor Olavi Ukkola, University of Oulu
Ambulatory blood pressure monitoring and adverse outcomes
Blood pressure varies throughout the day and night. Compared with office blood pressure, home blood pressure, especially at nighttime, has shown to have a stronger association with adverse outcomes. Ambulatory blood pressure monitoring (ABPM) is a method providing information on blood pressure in an everyday setting, including nighttime blood pressure and dipping status. Physiologically, blood pressure decreases 10–20% from the daytime to the nighttime (dipping). In some individuals, blood pressure does not decline. This phenomenon is called non-dipping, which is associated with cardiovascular events and mortality. This thesis studies dipping pattern change and pulse pressure, and their association with adverse outcomes in a 21-year follow-up.
Non-dipping blood pressure has also been associated with metabolic changes in earlier studies. In the present study, an association between dipping pattern change and new-onset diabetes during the follow-up was observed: non-dipping–non-dipping pattern was more common among those who developed diabetes.
Non-dipping pattern has been connected to cardiovascular events and mortality, although there is debate concerning the confounding effect of nighttime blood pressure. In the present study, non-dipping–non-dipping pattern was associated with non-fatal cardiovascular events independently of nighttime or 24-h systolic blood pressure.
Pulse pressure, i.e., the difference between systolic and diastolic blood pressure, widens with aging. High pulse pressure has been associated with adverse outcomes, especially in the elderly population. In our study, high 24-h and high nighttime pulse pressure in middle-age predicted cardiovascular and all-cause mortality.
In conclusion, blood pressure pattern change and pulse pressure measurements derived from 24-h ambulatory blood pressure monitoring were associated with adverse health outcomes in this population-based study with a 21-year follow-up.
Non-dipping blood pressure has also been associated with metabolic changes in earlier studies. In the present study, an association between dipping pattern change and new-onset diabetes during the follow-up was observed: non-dipping–non-dipping pattern was more common among those who developed diabetes.
Non-dipping pattern has been connected to cardiovascular events and mortality, although there is debate concerning the confounding effect of nighttime blood pressure. In the present study, non-dipping–non-dipping pattern was associated with non-fatal cardiovascular events independently of nighttime or 24-h systolic blood pressure.
Pulse pressure, i.e., the difference between systolic and diastolic blood pressure, widens with aging. High pulse pressure has been associated with adverse outcomes, especially in the elderly population. In our study, high 24-h and high nighttime pulse pressure in middle-age predicted cardiovascular and all-cause mortality.
In conclusion, blood pressure pattern change and pulse pressure measurements derived from 24-h ambulatory blood pressure monitoring were associated with adverse health outcomes in this population-based study with a 21-year follow-up.
Created 21.11.2025 | Updated 28.11.2025