Association of Ambulatory Blood Pressure Monitoring parameters with the Framingham Stroke Risk Profile

The Framingham Stroke Risk Profile (FSRP) is a novel and reliable tool for estimating the 10-year probability for incident stroke in stroke-free individuals, while the predictive value of ambulatory blood pressure monitoring (ABPM) for first-ever and recurrent stroke has been well established. We sought to evaluate cross-sectionally the association of ABPM parameters with FSRP score in a large sample of 2343 consecutive stroke-free individuals (mean age: 56.0 ± 12.9, 49.1% male) who underwent 24-hour ABPM. True hypertensives showed significantly higher FSRP (11.2 ± 5.0) compared to the normotensives (8.2 ± 5.0, p < 0.001), while subjects with white coat hypertension also had higher FSRP (10.2 ± 4.7) than normotensives (8.2 ± 5.0, p < 0.001). Compared to dippers that exhibited the lowest FSRP, non-dippers and reverse-dippers exhibited significantly higher FSRP (9.8 ± 4.8 for dippers vs 10.6 ± 5.2 and 11.5 ± 5.0 for non-dippers and reverse-dippers respectively, p ≤ 0.001 for comparisons). In univariate analyses, the ABPM parameters that had the strongest correlation with FSRP were 24-hour (r = 0.440, p < 0.001), daytime (r = 0.435, p < 0.001) and night-time (r = 0.423; p < 0.001) pulse pressure (PP). The best fitting model for predicting FSRP (R2 = 24.6%) on multiple linear regression analyses after adjustment for vascular risk factors not included in FSRP comprised the following parameters in descending order: 24-hour PP (β = 0.349, p < 0.001), daytime SBP variability (β = 0.124, p < 0.001), 24-hour HR variability (β = − 0.091, p < 0.001), mean 24-hour HR (β = − 0.107, p < 0.001), BMI (β = 0.081, p < 0.001) and dipping percentage (β = − 0.063, p = 0.001). 24-hour PP and daytime SBP variability are the two ABPM parameters that were more strongly associated with FSRP-score. Reverse dippers had the highest FSRP among all dipping status profiles.