Lower Sleep-Time BP Indicates Reduced Cardiovascular Risk

Each 5 mm Hg decrease in asleep systolic BP predicts a 17 percent reduction in CV risk

FRIDAY, Sept. 2 (HealthDay News) -- The asleep blood pressure mean, determined by ambulatory monitoring, independently predicts cardiovascular risk, with a progressive decrease in asleep blood pressure predicting a significantly reduced cardiovascular risk, according to a study published in the Sept. 6 issue of the Journal of the American College of Cardiology.

Ramón C. Hermida, Ph.D., from the University of Vigo in Spain, and colleagues investigated whether reduced cardiovascular risk was associated more with the progressive decrease of awake or asleep blood pressure determined by ambulatory monitoring. A total of 3,344 subjects with baseline hypertension (1,718 men and 1,626 women), with an average age of 52.6 years, were followed up for an average of 5.6 years. Participants were randomized to ingest either all their prescribed medications upon awakening or one or more of them at bedtime. Blood pressure measurements were taken for 48 hours at baseline, and repeated annually or quarterly, if treatment adjustment was required.

The investigators found that, at baseline, the cardiovascular risk was significantly predicted by asleep blood pressure in a Cox proportional hazards model adjusted for asleep blood pressure by awake mean, and by sex, age, and diabetes. A 17 percent reduction in the risk of cardiovascular events was observed for each 5 mm Hg decrease in asleep systolic blood pressure mean during analyses of changes in ambulatory blood pressure during follow-up, and this was independent of changes in any other ambulatory blood pressure parameter.

"The sleep-time blood pressure mean is the most significant prognostic marker of cardiovascular morbidity and mortality," the authors write.

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