Prognostic Value of Subdivisions of Nighttime Blood Pressure Fall in Hypertensives Followed Up for 8.2 Years. Does Nondipping Classification Need to Be Redefined?

• Type: Article in International Scientific Journal
• Date: 2010

Authors

Jose Mesquita Bastos (Author) Other; Susana Bertoquini (Author) Other; Jorge Polonia (Author) FMUP

Journal

Title: Journal of Clinical Hypertension

Vol. 12

Pages: 508-515

ISSN: 1524-6175

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 25 Citations

Scopus - 21 Citations

Scientific classification

FOS: Medical and Health sciences > Clinical medicine

Other information

Authenticus ID: P-003-5AJ

DOI: 10.1111/j.1751-7176.2010.00291.x

Abstract (EN): 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 >= 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 of CV risk.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 8