Prognostic value of subdivisions of nighttime blood pressure fall in hypertensives followed up for 8.2 years. Does nondipping classification need to be redefined?

The Journal of Clinical Hypertension
José Mesquita BastosJorge Polónia

Abstract

To evaluate the long-term prognostic significance of different ranges of the percentage fall in nighttime blood pressure (BP) of the nondipping pattern, 1200 hypertensive patients (645 women, age 51+/-12 years) underwent ambulatory BP monitoring under stabilized therapy. The occurrence of cardiovascular (CV) events was followed for 9833 patient-years and analyzed by the Cox hazard model. There were 152 CV fatal/nonfatal events (79 strokes, 51 coronary events, 22 others) during the 15.2 years of follow-up. According to nighttime BP fall (%) the authors noted: <0% (reverse-dippers [RD], n=83); 0%-4.9% (nondippers 1 [ND1], n=207); 5%-9.9% (nondippers 2 [ND2], n=311), 10%-19.9% (dippers [D], n=523); and > or =20% (extreme dippers [ED], n=76). After adjustment for confounding variables, hazard ratios (95% confidence interval) of CV event and stroke in RD vs D were 2.29 (1.31-3.99) and 2.46 (1.11-5.49); of ND1 vs D were 1.42 (1.12-1.79) and 1.62 (1.17-2.23); and of ND1 vs ND2 were 2.24 (1.33-3.75) and 2.30 (1.15-4.58). No differences were found in RD vs ND1 and ND2 vs D. Nondippers have a higher CV risk than dippers but only for a nighttime BP fall <5% suggesting that the limits for nondipping should be redefined for a stratification...Continue Reading

References

Aug 13, 1988·Lancet·E O'BrienK O'Malley
Dec 16, 1997·American Journal of Hypertension·T OhkuboS Hisamichi
Apr 17, 1998·American Journal of Hypertension·I KohnoK Tamura
Apr 29, 1998·Aging : Clinical and Experimental Research·G AbateA Di Iorio
Dec 1, 1998·American Journal of Hypertension·A L FerraraA Celentano
May 8, 1999·American Journal of Hypertension·S D PierdomenicoA Mezzetti
Aug 24, 2001·Journal of Hypertension·E LurbeV Alvarez
Aug 13, 2002·Journal of Hypertension·Kristina BjörklundHans Lithell
Jun 13, 2003·The New England Journal of Medicine·Denis L ClementUNKNOWN Office versus Ambulatory Pressure Study Investigators

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