Although the prognostic value of the day-night blood pressure (BP) changes is established, the most appropriate method for defining day and night is undefined. We assessed the prognostic value of the day-night BP changes by using three definitions of day and night in 2,934 initially untreated hypertensive subjects who underwent 24-hour ambulatory BP monitoring. Over a median follow-up period of 7 years, there were 356 cardiovascular events and 176 deaths. Total cardiovascular events and all-cause mortality were similarly higher in non-dippers (night/day ratio of systolic BP >10\% or >0\%) than in dippers regardless of the definition of day and night. In a receiver-operated characteristic (ROC) curve analysis of the night/day ratio of systolic BP on the occurrence of events, the area under the ROC curve did not differ among the different definitions of day and night (large fixed-clock intervals, narrow fixed-clock intervals, diary) for both total cardiovascular events (0.61 [95\% confidence interval (CI): 0.58 to 0.64], 0.61 [95\% CI: 0.57 to 0.63], 0.62 [95\% CI: 0.58 to 0.65], respectively; P = 0.20) and all-cause mortality (0.65 [95\% CI: 0.61 to 0.70], 0.64 [95\% CI: 0.60 to 0.69], 0.65 [95\% CI: 0.61 to 0.70], respectively; P = 0.78). The prognostic value of the diurnal BP changes is comparable when using different clock-dependent or independent definitions of day and night.

Prognostic value of circadian blood pressure changes in relation to differing measures of day and night.

REBOLDI, Gianpaolo
2008

Abstract

Although the prognostic value of the day-night blood pressure (BP) changes is established, the most appropriate method for defining day and night is undefined. We assessed the prognostic value of the day-night BP changes by using three definitions of day and night in 2,934 initially untreated hypertensive subjects who underwent 24-hour ambulatory BP monitoring. Over a median follow-up period of 7 years, there were 356 cardiovascular events and 176 deaths. Total cardiovascular events and all-cause mortality were similarly higher in non-dippers (night/day ratio of systolic BP >10\% or >0\%) than in dippers regardless of the definition of day and night. In a receiver-operated characteristic (ROC) curve analysis of the night/day ratio of systolic BP on the occurrence of events, the area under the ROC curve did not differ among the different definitions of day and night (large fixed-clock intervals, narrow fixed-clock intervals, diary) for both total cardiovascular events (0.61 [95\% confidence interval (CI): 0.58 to 0.64], 0.61 [95\% CI: 0.57 to 0.63], 0.62 [95\% CI: 0.58 to 0.65], respectively; P = 0.20) and all-cause mortality (0.65 [95\% CI: 0.61 to 0.70], 0.64 [95\% CI: 0.60 to 0.69], 0.65 [95\% CI: 0.61 to 0.70], respectively; P = 0.78). The prognostic value of the diurnal BP changes is comparable when using different clock-dependent or independent definitions of day and night.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11391/169642
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