TY - JOUR
T1 - Is blood pressure during the night more predictive of Cardiovascular Outcome than during the day?
AU - Li, Yan
AU - Boggia, José
AU - Thijs, Lutgarde
AU - Hansen, Tine W.
AU - Kikuya, Masahiro
AU - Björklund-Bodegård, Kristina
AU - Richart, Tom
AU - Ohkubo, Takayoshi
AU - Kuznetsova, Tatiana
AU - Torp-Pedersen, Christian
AU - Lind, Lars
AU - Ibsen, Hans
AU - Imai, Yutaka
AU - Wang, Jiguang
AU - Sandoya, Edgardo
AU - O'brien, Eoin
AU - Staessen, Jan A.
PY - 2008/6
Y1 - 2008/6
N2 - The objective of this study was to investigate the prognostic significance of the ambulatory blood pressure (BP) during night and day and of the night-to-day BP ratio (NDR). We studied 7458 participants (mean age 56.8 years; 45.8% women) enrolled in the International Database on Ambulatory BP in relation to Cardiovascular Outcome. Using Cox models, we calculated hazard ratios (HR) adjusted for cohort and cardiovascular risk factors. Over 9.6 years (median), 983 deaths and 943 cardiovascular events occurred. Nighttime BP predicted mortality outcomes (HR, 1.18-1.24; P<0.01) independent of daytime BP. Conversely, daytime systolic (HR, 0.84; P<0.01) and diastolic BP (HR, 0.88; P<0.05) predicted only noncardiovascular mortality after adjustment for nighttime BP. Both daytime BP and nighttime BP consistently predicted all cardiovascular events (HR, 1.11-1.33; P<0.05) and stroke (HR, 1.21-1.47; P<0.01). Daytime BP lost its prognostic significance for cardiovascular events in patients on antihypertensive treatment. Adjusted for the 24-h BP, NDR predicted mortality (P<0.05), but not fatal combined with nonfatal events. Participants with systolic NDR of at least 1 compared with participants with normal NDR (≥0.80 to <0.90) were older, at higher risk of death, but died at higher age. The predictive accuracy of the daytime and nighttime BP and the NDR depended on the disease outcome under study. The increased mortality in patients with higher NDR probably indicates reverse causality. Our findings support recording the ambulatory BP during the whole day. Blood Press Monit 13:145-147
AB - The objective of this study was to investigate the prognostic significance of the ambulatory blood pressure (BP) during night and day and of the night-to-day BP ratio (NDR). We studied 7458 participants (mean age 56.8 years; 45.8% women) enrolled in the International Database on Ambulatory BP in relation to Cardiovascular Outcome. Using Cox models, we calculated hazard ratios (HR) adjusted for cohort and cardiovascular risk factors. Over 9.6 years (median), 983 deaths and 943 cardiovascular events occurred. Nighttime BP predicted mortality outcomes (HR, 1.18-1.24; P<0.01) independent of daytime BP. Conversely, daytime systolic (HR, 0.84; P<0.01) and diastolic BP (HR, 0.88; P<0.05) predicted only noncardiovascular mortality after adjustment for nighttime BP. Both daytime BP and nighttime BP consistently predicted all cardiovascular events (HR, 1.11-1.33; P<0.05) and stroke (HR, 1.21-1.47; P<0.01). Daytime BP lost its prognostic significance for cardiovascular events in patients on antihypertensive treatment. Adjusted for the 24-h BP, NDR predicted mortality (P<0.05), but not fatal combined with nonfatal events. Participants with systolic NDR of at least 1 compared with participants with normal NDR (≥0.80 to <0.90) were older, at higher risk of death, but died at higher age. The predictive accuracy of the daytime and nighttime BP and the NDR depended on the disease outcome under study. The increased mortality in patients with higher NDR probably indicates reverse causality. Our findings support recording the ambulatory BP during the whole day. Blood Press Monit 13:145-147
KW - Ambulatory blood pressure monitoring
KW - Blood pressure
KW - Cardiovascular Outcome
UR - http://www.scopus.com/inward/record.url?scp=48849102207&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=48849102207&partnerID=8YFLogxK
U2 - 10.1097/MBP.0b013e3282fd16cc
DO - 10.1097/MBP.0b013e3282fd16cc
M3 - Article
C2 - 18496289
AN - SCOPUS:48849102207
VL - 13
SP - 145
EP - 147
JO - Blood Pressure Monitoring
JF - Blood Pressure Monitoring
SN - 1359-5237
IS - 3
ER -