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Is nighttime blood pressure important in cardiovascular risk assessment in coronary atherosclerosis?

W Sobiczewski1, M Wirtwein2, M Gruchala1

  • 1I Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.

Journal of Human Hypertension
|January 17, 2014
PubMed

Insights

Elevated nighttime blood pressure (BP) is linked to increased major adverse cardiac events (MACE) in hypertensive patients with coronary atherosclerosis. Monitoring nocturnal BP may improve cardiovascular risk assessment in this population.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Preventive Cardiology

Background:

  • Nighttime blood pressure (BP) is crucial for cardiovascular risk assessment in the general population.
  • The prognostic significance of elevated nighttime BP in hypertensive patients with established coronary atherosclerosis remains unclear.
  • The PROGNOSIS study investigated the association between abnormal nighttime BP and major adverse cardiac events (MACE) in this specific patient group.

Discussion:

  • A higher prevalence of abnormal nighttime BP (≥120/70 mmHg) was observed in patients who experienced MACE compared to those who did not.
  • Cumulative incidence curves indicated a significantly higher risk of MACE during the follow-up period for individuals with abnormal nighttime BP.
  • These findings suggest that elevated nighttime BP is an independent contributor to cardiovascular risk in patients with confirmed coronary atherosclerosis.

Key Insights:

  • Abnormal nighttime BP is more prevalent in hypertensive patients with coronary atherosclerosis who experience MACE.
  • Hypertensive patients with coronary atherosclerosis and elevated nighttime BP face a greater risk of MACE.
  • Nighttime BP monitoring can be a valuable tool for risk stratification in patients with coronary artery disease.

Outlook:

  • Further research is warranted to elucidate the mechanisms underlying the association between nighttime BP and MACE.
  • Integrating nighttime BP monitoring into routine clinical practice may enhance cardiovascular risk prediction in patients with coronary atherosclerosis.
  • Investigating therapeutic strategies targeting nighttime hypertension could potentially reduce MACE in this vulnerable population.

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