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Diurnal blood pressure pattern and risk of congestive heart failure
Erik Ingelsson1, Kristina Björklund-Bodegård, Lars Lind
1Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden. erik.ingelsson@pubcare.uu.se
JAMA
|June 29, 2006
Summary
Nighttime blood pressure patterns, specifically "nondipping," significantly predict congestive heart failure (CHF) risk in elderly men. This finding offers new insights beyond traditional blood pressure measurements for CHF prevention.
Area of Science:
- Cardiology
- Hypertension Research
- Preventive Medicine
Background:
- High blood pressure is a primary risk factor for congestive heart failure (CHF).
- The impact of altered diurnal blood pressure patterns on subsequent CHF risk is not well understood.
Purpose of the Study:
- To evaluate 24-hour ambulatory blood pressure characteristics as predictors of CHF incidence.
- To determine if altered diurnal blood pressure patterns provide additional risk information beyond conventional office measurements.
Main Methods:
- Prospective, community-based observational cohort study of 951 elderly men without CHF at baseline.
- 24-hour ambulatory blood pressure monitoring performed at baseline.
- Analysis of blood pressure variables as predictors of subsequent CHF hospitalization.
Main Results:
- A 1-SD increase in nighttime diastolic blood pressure (HR, 1.26) and "nondipping" blood pressure (HR, 2.29) were associated with increased CHF risk.
- "Nondipping" remained a significant predictor even after adjusting for office blood pressure measurements (HR, 2.21).
- These associations persisted after excluding participants with myocardial infarction.
Conclusions:
- Nighttime blood pressure patterns, particularly "nondipping," provide significant risk information for CHF.
- This information is incremental to conventional office blood pressure readings and established risk factors.
- Further research is needed to establish the clinical utility of these findings.
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