TABLE 2.
Nighttime BP and cardiovascular events.
| Study author, year | Patient population | Sample size | Main results |
|---|---|---|---|
| IDACO investigators, 2007 13 | Participants with ABPM in Denmark, Belgium, Japan, Sweden, Uruguay, and China | 7458 | Adjusted for daytime BP, nighttime BP predicted total (n = 983; p < .0001), cardiovascular (n = 387; p < .01), and non‐cardiovascular (n = 560; p < .001) mortality. Conversely, adjusted for nighttime BP, daytime BP predicted only non‐cardiovascular mortality (p < .05), with lower BP levels being associated with increased risk. |
| IDACO investigators, 2010 24 | Participants of Europeans, Asians, and South Americans with ABPM | 8711 | Compared with daytime BP, nighttime BP was more closely related to fatal and non‐fatal cardiovascular event, especially in patients with antihypertensive treatment. Compared with isolated nocturnal hypertensive patients and isolated daytime hypertensive patients, those with day‐night sustained hypertension had the highest risk of all‐cause mortality(HR 1.51, p < .001), all cardiovascular events (HR 2.48, p < .001) and cardiovascular mortality (HR 2.19, p < .001); isolated nocturnal hypertension was associated with increased risk of all‐cause mortality (HR 1.29, p = .045) and all cardiovascular events (HR 1.38, p = .037); compared with isolated daytime hypertension (HR 1.07, p = .56), isolated nocturnal hypertension was more closely associated with the increase of all‐cause mortality risk. |
| Roush GC, 2014 11 | Nine hypertensive cohorts from Europe, Brazil, and Japan | 13 844 | Compared with daytime systolic BP and clinic systolic BP, increased nighttime systolic BP independently predicted higher cardiovascular events in most cohorts, and, overall, nighttime systolic BP independently predicted cardiovascular events, whereas clinic systolic BP and daytime systolic BP lost their predictive ability entirely. |
| Salles GF, 2016 39 | Hypertensive patients | 17 312 | Compared with dipper hypertension, non‐dipper/reverse dipper was associated with higher risk of cardiovascular events. |
| Fujiwara T, 2020 40 | Outpatients with a history of CVD or risk factors who performed nocturnal HBPM | 2745 | The cumulative incidence of CVD events was higher in those with masked nocturnal hypertension and sustained hypertension than in the controlled BP group. Results from Cox models suggested that masked nocturnal hypertension (adjusted hazard ratio, 1.57 [95% CI, 1.00−2.46]) and sustained hypertension (adjusted hazard ratio, 1.97 [95% CI, 1.26−3.06]) were associated with increased risk of CVD events. |
| Kario K, 2020 41 | Patients with at least one cardiovascular risk factor | 6359 | Nighttime BP level and reverse dipper pattern were independently associated with the risk of total cardiovascular events, especially heart failure. |
| Wang Q, 2021 12 | Patients with CKD stages 1−4 | 2024 | Isolated nocturnal systolic hypertension increased the risk of cardiovascular events (HR 3.17; 95% CI 1.61‐6.23), nocturnal systolic‐diastolic hypertension increased the risk of renal failure (HR 1.71; 95% CI 1.17–2.49) and cardiovascular events (HR 2.19; 95%CI 1.24–3.86). |
| Fu X, 2022 19 | CKD patients | 675 | Isolated nighttime masked uncontrolled hypertension was significantly associated with increased risk of the composite kidney outcome (HR 4.27, 95%CI 1.69–10.77); day‐night masked uncontrolled hypertension was significantly associated with the increased risk of left ventricular hypertrophy (OR 3.26, 95%CI 1.15–9.25). |
Abbreviations: ABPM, ambulatory blood pressure monitoring; BP, blood pressure; CI, confidence interval; CKD, chronic kidney disease; CVD, cardiovascular disease; HBPM, home blood pressure monitoring; HR, hazard ratio; IDACO, international database on ambulatory blood pressure monitoring in relation to cardiovascular outcomes; OR, odds ratio.