Nocturnal blood pressure non-dipping and reverse dipping demonstrated adverse cardiovascular prognosis in Chinese patients with hypertension, with adjusted hazard ratios for total cardiovascular events of 1.166 and 1.173, respectively.
Cohort (n=1,199)
Sí
Does nocturnal blood pressure non-dipping or reverse dipping increase the risk of cardiovascular events in Chinese patients with hypertension?
Nocturnal blood pressure non-dipping and reverse dipping are associated with adverse cardiovascular prognosis in Chinese patients with hypertension, highlighting the value of ABPM for risk stratification.
Estimación del efecto: HR 1.166 (95% CI 0.770-1.764)
valor p: p=0.469
Meta-analyses showed that non-dipping of nocturnal blood pressure on ambulatory blood pressure monitoring (ABPM) was associated with adverse cardiovascular prognosis. However, these prognostic studies were mainly conducted in Caucasian and Japanese populations. Whether this association applies to Chinese patients remained uninvestigated. A total of 1199 Chinese patients with hypertension undergoing ABPM between January 2012 and December 2014 were recruited retrospectively from five public hypertension referral clinics in Hong Kong. Patients were followed up for a mean 6.42 years for cardiovascular morbidity and mortality and all-cause mortality. Time to event of different dipping patterns was compared by Kaplan-Meier curves. Hazard ratios (HR) were obtained by Cox proportional hazard models with patient demographics and confounding factors adjusted in multivariate regression. A total of 163 end point events occurred in the period. Normal dipping was observed in 446 patients (37.2%), non-dipping in 490 (40.9%), reverse dipping in 161 (13.4%), and extreme dipping in 102 (8.5%). Kaplan-Meier analyses showed inferior survival in non-dippers and reverse dippers for total cardiovascular events and coronary events but not cerebrovascular events. After adjusting for confounding factors, Cox regressions showed HRs 1.166 (CI 0.770-1.764) and 1.173 (CI 0.681-2.021) in non-dippers and reverse dippers for total cardiovascular events, and HRs 1.320 (CI 0.814-2.141) and 1.476 (CI 0.783-2.784) for coronary events. Nocturnal blood pressure non-dipping, and to a greater extent reverse dipping, demonstrated adverse cardiovascular prognosis in a cohort of Chinese patients with hypertension in Hong Kong. Further focused studies on cerebrovascular events and reverse dippers were warranted to refine risk stratification.
Lo et al. (Wed,) conducted a cohort in Hypertension (n=1,199). Nocturnal blood pressure non-dipping vs. Normal dipping was evaluated on Total cardiovascular events (HR 1.166, 95% CI 0.770-1.764, p=0.469). Nocturnal blood pressure non-dipping and reverse dipping demonstrated adverse cardiovascular prognosis in Chinese patients with hypertension, with adjusted hazard ratios for total cardiovascular events of 1.166 and 1.173, respectively.