Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study
Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study
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DOI：
10.1097/00004872-200211000-00017
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发表时间：
2002-11-01
影响因子：
4.9
通讯作者：
Imai, Y
中科院分区：
文献类型：
--
作者：
Ohkubo, T;Hozawa, A;Imai, Y
目的 研究 24 小时血压值升高或不升高的个体夜间血压正常下降与心血管死亡风险之间的关系。方法 我们获得了 1542 名日本大坂町居民的 24 小时动态血压读数，这些居民年龄在 40 岁或以上，代表了日本一般人群。然后我们对他们的平均生存期进行了 9.2 年的随访。使用针对可能的混杂因素进行调整的 Cox 比例风险模型来分析这种关系。结果 夜间血压下降与心血管死亡率之间存在线性关系。平均而言，夜间收缩压/舒张压每下降 5%，心血管死亡风险就会增加约 20%。 24 小时收缩压/舒张压值与夜间血压下降的连续值之间的风险没有显着的交互作用（交互作用 P > 0.6）。即使 24 小时血压值在正常范围内（< 135/80 mmHg，平均 118/69 mmHg），夜间收缩压/舒张压下降的减弱也与心血管死亡风险的增加相关。 结论 这是第一项研究证明，夜间血压下降的减弱是心血管死亡的一个危险因素，与 24 小时内的总体血压负荷无关，在普通民众。 (C) 2002 年利平科特·威廉姆斯·威尔金斯。
Objective To examine the relationship between the normal nocturnal decline in blood pressure and the risk of cardiovascular mortality in individuals with and without high 24-h blood pressure values.Methods We obtained 24-h ambulatory blood pressure readings from 1542 residents of Ohasama, Japan, who were aged 40 years or more and were representative of the Japanese general population. We then followed up their survival for a mean of 9.2 years. The relationship was analysed using a Cox proportional hazards model adjusted for possible confounding factors.Results There was a linear relationship between the nocturnal decline in blood pressure and cardiovascular mortality. On average, each 5% decrease in the decline in nocturnal systolic/diastolic blood pressure was associated with an approximately 20% greater risk of cardiovascular mortality. There were no significant interactions for the risk between 24-h systolic/diastolic blood pressure values and continuous values for the nocturnal decline in blood pressure (P for interaction > 0.6). Even when 24-h blood pressure values were within the normal range (< 135/80 mmHg, average 118/69 mmHg), diminished nocturnal decreases in systolic/diastolic blood pressure were associated with an increased risk of cardiovascular mortality.Conclusions This is the first study to demonstrate that a diminished nocturnal decline in blood pressure is a risk factor for cardiovascular mortality, independent of the overall blood pressure load during a 24-h period, in the general population. (C) 2002 Lippincott Williams Wilkins.