Is daytime blood pressure adequate in cardiovascular risk assessment in patients with coronary atherosclerosis?

Related Experiment Video

Updated: May 9, 2026

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis
07:51

Hydra, a Computer-Based Platform for Aiding Clinicians in Cardiovascular Analysis and Diagnosis

Published on: September 26, 2018

Wojciech Sobiczewski1, Marcin Wirtwein, Marcin Gruchala

  • 1I Department of Cardiology, Medical University of Gdansk , Debinki 7, 80-211 Gdansk , Poland.

Blood Pressure
|August 1, 2013
PubMed

Insights

Abnormal night-time blood pressure (BP) significantly increases cardiovascular (CV) mortality risk in hypertensive patients with coronary artery disease. Monitoring both daytime and night-time BP is crucial for accurate CV risk assessment.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Medicine

Background:

  • Hypertension is a major risk factor for cardiovascular disease.
  • Night-time blood pressure (BP) patterns are increasingly recognized as important predictors of cardiovascular (CV) events.
  • Patients with established coronary artery disease (CAD) and hypertension require precise risk stratification.

Purpose of the Study:

  • To estimate the impact of abnormal night-time blood pressure (BP) on cardiovascular (CV) mortality.
  • To evaluate the role of both daytime and night-time BP in hypertensive patients with significant atherosclerosis.
  • To compare the predictive value of clinic BP versus ambulatory BP monitoring for CV outcomes.

Main Methods:

  • A cohort of 891 hypertensive patients with confirmed coronary artery disease was studied.
  • Patients were categorized based on normal or abnormal daytime BP values.
  • Cardiovascular (CV) and all-cause mortality were assessed over a 4.7-year follow-up period.

Main Results:

  • Abnormal daytime BP was associated with a 1.80-fold increased hazard of CV mortality (p < 0.02).
  • Abnormal night-time BP was linked to a 1.63-fold increased hazard of CV mortality (p < 0.04).
  • CV mortality was significantly lower in patients with normal daytime BP compared to those with abnormal daytime BP (5.6% vs 9.8%, p < 0.02).

Conclusions:

  • Assessment of both daytime and night-time blood pressure (BP) is essential for cardiovascular (CV) risk evaluation.
  • Ambulatory BP monitoring, encompassing both daytime and night-time readings, is superior to clinic BP for CV risk assessment in patients with coronary artery disease.
  • Accurate BP monitoring is critical for managing hypertensive patients with established atherosclerosis.
Abstract

Related Concept Videos

Coronary Artery Disease IV: Preventive Measures01:26

Coronary Artery Disease IV: Preventive Measures

Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
Coronary Artery Disease I: Introduction01:30

Coronary Artery Disease I: Introduction

Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests01:27

Atherosclerosis II: Clinical Manifestations and Diagnostic Tests

Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...
Assessment of blood pressure in brachial artery(one-step method)01:15

Assessment of blood pressure in brachial artery(one-step method)

This procedural guide systematically measures blood pressure using an oscillometric digital sphygmomanometer, emphasizing accuracy, patient safety, and comfort.
Prepare for the Procedure:
Hypertension III: Clinical Manifestations and Diagnostic Studies01:30

Hypertension III: Clinical Manifestations and Diagnostic Studies

Hypertension is asymptomatic and also referred to as the "silent killer" until it progresses to a severe stage or causes target organ disease. Patients may experience symptoms stemming from the strain on blood vessels and tissues in various organs or the heart's increased workload.Physical exams might show no abnormalities other than high blood pressure. Signs of vascular damage, when present, correspond to the organs supplied by the affected vessels, leading to target organ damage. For...