Key result
Higher nocturnal SBP is linked to ~15% higher CVD risk per 10 mmHg in octogenarians.
Why the study?
Nocturnal blood pressure is a stronger predictor of cardiovascular disease events than office or daytime blood pressure, but its clinical significance in individuals aged ≥80 years compared with younger individuals remained unclear.
Does higher nocturnal systolic blood pressure increase the risk of cardiovascular disease events in individuals aged ≥80 years compared with those aged <80 years?
Cohort (n=6,359)
Does higher nocturnal systolic blood pressure increase the risk of cardiovascular disease events in individuals aged ≥80 years compared with those aged <80 years?
Nocturnal systolic blood pressure has clear prognostic value for cardiovascular events in very elderly individuals (≥80 years), with each 10-mmHg increase linked to a 15% higher risk, supporting nocturnal BP screening in this age group.
Answers are grounded in this paper and cite their sources.
Nocturnal SBP associated with higher CVD risk in adults ≥80 years; extends prior evidence but remains hypothesis-generating and should not yet change practice.
Background Nocturnal blood pressure (BP) is a stronger predictor of cardiovascular disease (CVD) events than office or daytime BP. However, its clinical significance in the very elderly (≥80 years) compared with younger individuals remains unclear. Purpose To examine the association between nocturnal BP and CVD events in individuals aged ≥80 versus <80 years. Methods We analyzed data from the Japan Ambulatory Blood Pressure Monitoring Prospective (JAMP) Study, including 6,359 participants with cardiovascular risk factors (mean age 69±12 years; 52% women; 77% on antihypertensive medications). All underwent baseline 24-h ambulatory BP monitoring. Nocturnal systolic BP (SBP) was divided into quintiles, and associations with total CVD events (coronary artery disease, stroke, and heart failure) were assessed using Cox regression. Results During 4.5±2.4 years of follow-up, 306 CVD events occurred. In 1,046 individuals aged ≥80 years, each 10-mmHg higher nocturnal SBP was associated with greater CVD risk (HR 1.15, 95% CI 1.03–1.29), with a U-shaped relationship (Fig.). This association was not observed in those aged <80 years (HR 1.08, 95% CI 0.99–1.16). Conclusions The impact of nocturnal BP differed by age, showing clear prognostic value in those ≥80 years. Screening for nocturnal BP may help identify high-risk elderly individuals.
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Fujiwara et al. (2026) conducted a cohort in Cardiovascular risk factors (n=6,359). Nocturnal systolic blood pressure (per 10-mmHg increase) vs. Individuals aged <80 years vs ≥80 years / lower nocturnal SBP quintiles was evaluated on Total cardiovascular disease events (coronary artery disease, stroke, and heart failure) (HR 1.15, 95% CI 1.03-1.29). Each 10-mmHg higher nocturnal SBP increased CVD risk in adults ≥80 years (HR 1.15, 95% CI 1.03-1.29), an association not observed in those <80 years (HR 1.08, 95% CI 0.99-1.16).
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