1. Is the definition of daytime and nighttime blood pressure prognostically relevant?
- Author
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Verdecchia P, Angeli F, Sardone M, Borgioni C, Garofoli M, and Reboldi G
- Subjects
- Blood Pressure Monitoring, Ambulatory methods, Cardiovascular Diseases complications, Follow-Up Studies, Humans, Hypertension complications, Italy epidemiology, ROC Curve, Sensitivity and Specificity, Blood Pressure physiology, Cardiovascular Diseases mortality, Circadian Rhythm physiology, Hypertension diagnosis, Hypertension mortality
- Abstract
Objectives: Although the prognostic value of the day-night blood pressure (BP) changes is well established, the most appropriate method for definition of daytime and nighttime BP is still undefined. In a recent guidelines document of the European Society of Hypertension, there is no clear position in favor of one definition over other., Methods: In the setting of the Progetto Ipertensione Umbria Monitoraggio Ambulariale study, we analyzed the prognostic impact of the day-night BP changes by using three widely used different definitions of day and night (large fixed-clock intervals, narrow fixed-clock intervals, diary) in 2934 initially untreated participants with essential hypertension., Results: Three hundred and fifty-six cardiovascular events and 176 deaths over a median follow-up period of 7 years were observed. Nondippers showed a higher risk of total cardiovascular events and all-cause mortality than dippers regardless of the definition of day and night. Furthermore, the area under a receiver-operated characteristic curve analysis did not differ among the different definitions of day and night (large fixed-clock intervals, narrow fixed-clock intervals, diary) for total cardiovascular events and all-cause mortality (all P=NS)., Conclusion: The data suggest that the prognostic value of the diurnal BP changes is comparable when day and night are defined using large fixed-clock intervals, narrow fixed-clock intervals, or actual time spent in and out of bed.
- Published
- 2008
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