A reverse dipping pattern predicts cardiovascular mortality in a clinical cohort

Area of Science:

• Cardiology
• Hypertension Research
• Clinical Epidemiology

Background:

• Abnormal dipping patterns in ambulatory blood pressure monitoring (ABPM) are recognized cardiovascular risk factors.
• The clinical impact of these patterns on cardiovascular (CV) mortality requires further investigation for standard parameter consideration.

Purpose of the Study:

• To assess the association between abnormal dipping patterns and increased CV mortality.
• To investigate the clinical significance of blood pressure dipping in a Korean tertiary hospital cohort.

Main Methods:

• Retrospective cohort study of 401 patients undergoing ABPM (1994-1996).
• Patients categorized into 'risers' (<0% systolic BP drop) and 'others' (dippers and non-dippers).
• 120-month follow-up for CV mortality using Cox regression analysis, adjusting for covariates.

Main Results:

• CV mortality was 14.0% in risers versus 5.8% in others.
• Risers showed a significantly greater risk of CV death (RR, 3.02; P=0.022) after adjustment.
• No significant difference in event rates was observed between dippers and non-dippers.

Conclusions:

• The 'riser' blood pressure dipping pattern is strongly associated with increased CV mortality.
• Abnormal dipping patterns, particularly reverse dipping, may be more prevalent in clinical practice.
• These findings highlight the prognostic value of ABPM dipping patterns in cardiovascular risk assessment.