Key result
A 1-SD increase in the systolic night-to-day ratio predicted all cardiovascular outcomes and mortality (HRs 1.12 to 1.23), independent of 24-hour systolic blood pressure levels.
Why the study?
Does abnormal nocturnal systolic blood pressure fall predict cardiovascular events and mortality in hypertensive patients?
Population
17,312 hypertensive patients from 3 continents
Comparison
Nocturnal systolic blood pressure fall vs Normal dippers
Design
Meta-analysis
Authors
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Supports incorporating nocturnal dipping ratio into ambulatory BP monitoring for refined risk stratification; extends independent prognostic evidence beyond 24-hour SBP.
Meta-Analysis (n=17,312)
Yes
Does abnormal nocturnal systolic blood pressure fall predict cardiovascular events and mortality in hypertensive patients?
Effect estimate: HR 1.12 to 1.23
The nocturnal blood pressure fall provides substantial prognostic information for cardiovascular events and mortality in hypertensive patients, independent of 24-hour SBP levels.
Salles et al. (2016) conducted a meta-analysis in Hypertension (n=17,312). Systolic night-to-day ratio and dipping patterns vs. Normal dippers (for dipping patterns) was evaluated on Total cardiovascular events, coronary events, strokes, cardiovascular mortality, and total mortality (HR 1.12 to 1.23). A 1-SD increase in the systolic night-to-day ratio predicted all cardiovascular outcomes and mortality (HRs 1.12 to 1.23), independent of 24-hour systolic blood pressure levels.