Nocturnal blood pressure decline based on different time intervals and long-term cardiovascular risk: the Ohasama Study
Nocturnal blood pressure decline based on different time intervals and long-term cardiovascular risk: the Ohasama Study
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DOI：
10.1080/10641963.2016.1259324
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发表时间：
2018-01
影响因子：
12.3
通讯作者：
M. Satoh;K. Asayama;M. Kikuya;R. Inoue;M. Tsubota-Utsugi;T. Obara;K. Murakami;A. Matsuda;T. Murakami;K. Nomura;H. Metoki;Y. Imai;T. Ohkubo
中科院分区：
文献类型：
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作者：
M. Satoh;K. Asayama;M. Kikuya;R. Inoue;M. Tsubota-Utsugi;T. Obara;K. Murakami;A. Matsuda;T. Murakami;K. Nomura;H. Metoki;Y. Imai;T. Ohkubo
摘要夜间血压（BP）下降的减少是心血管疾病的危险因素。为了定义日间和夜间动态BP，当基于日记的睡眠时间信息不可用时，使用时钟时间依赖性方法。我们的目的是比较固定的时钟间隔与日记记录，以确定夜间血压下降作为一般人群长期心血管风险的预测因子。数据来自日本Ohasama的1714名无心血管疾病史的参与者（平均年龄60.6岁; 64.9%为女性）。我们将夜间收缩压下降≥ 20%、10- 19%定义为极端杓型、杓型、非杓型和杓型。0- 9%和<0%。在平均17.0年的随访期内，发生了206例心血管死亡。根据日记记录，与杓型相比，极杓型患者心血管死亡的多变量校正风险比（HR）为1.24（95%置信区间[CI]，0.82-1.87），非杓型患者为1.21（0.87-1.69），在杓型患者中观察到的最高HR为2.31（1.47-3.62）。使用标准固定时钟间隔（白天09：00-21：00;夜间01：00-06：00）、夜间2 h-早移固定时钟（白天09：00-21：00;夜间23：00-04：00）或夜间2 h-晚移固定时钟（白天09：00-21：00;夜间03：00-08：00），与杓型相比，杓型的HR（95%CI）分别为1.57（1.08-2.27）、2.02（1.33-3.05）或1.29（0.86-1.92）。虽然使用日记记录仍然是可取的，标准和夜间2小时提前移动固定时钟的时间间隔似乎可行的人群为基础的研究。
ABSTRACT A diminished nocturnal decline in blood pressure (BP) represents a risk factor for cardiovascular disease. To define daytime and nighttime ambulatory BP, clock time-dependent methods are used when information on diary-based sleeping time is unavailable. We aimed to compare fixed-clock intervals with diary records to identify nocturnal BP declines as a predictor of long-term cardiovascular risk among the general population. Data were obtained from 1714 participants with no history of cardiovascular disease in Ohasama, Japan (mean age, 60.6 years; 64.9% women). We defined extreme dippers, dippers, non-dippers, and risers as nocturnal systolic BP decline ≥20%, 10–19%. 0–9%, and <0%, respectively. Over a mean follow-up period of 17.0 years, 206 cardiovascular deaths occurred. Based on diary records, multivariable-adjusted hazard ratios (HRs) for cardiovascular death compared with dippers were 1.24 (95% confidence interval [CI], 0.82–1.87) in extreme dippers, 1.21 (0.87–1.69) in non-dippers, and the highest HR of 2.31 (1.47–3.62) was observed in risers. Using a standard fixed-clock interval (daytime 09:00–21:00; nighttime 01:00–06:00), a nighttime 2 h-early shifted fixed-clock (daytime 09:00–21:00; nighttime 23:00–04:00), or a nighttime 2 h-late shifted fixed-clock (daytime 09:00–21:00; nighttime 03:00–08:00), the HR (95%CI) in risers compared with dippers was 1.57 (1.08–2.27), 2.02 (1.33–3.05), or 1.29 (0.86–1.92), respectively. Although use of diary records remains preferable, the standard and nighttime 2 h-early shifted fixed-clock intervals appear feasible for population-based studies.