Having a relatively high blood pressure level at night may increase the risk for congestive heart failure.

Congestive heart failure ( CHF ) is one of the most common, costly, disabling, and deadly diseases. Once diagnosed as having CHF, patients have a 1 in 3 chance of dying within 1 year and a 2 in 3 chance of dying within 5 years.
The death rate associated with CHF exceeds that of most cancers, although recent reports suggest an improving prognosis. The predominant causes of congestive heart failure are hypertension and coronary heart disease, and high blood pressure ( BP ) is suggested to be the most important risk factor for CHF.
Previous studies have established that 24-hour BP measurements, which provide information that is not obtained from conventional office-based BP measurement, such as average BP over a 24-hour period and night-day patterns, are powerful predictors of cardiovascular illness and death. However, no previous studies have examined 24-hour ambulatory (as opposed to office-measured) blood pressure as a predictor of congestive heart failure in persons free of CHF at baseline.

Erik Ingelsson, of Uppsala University, Uppsala, Sweden, and colleagues analyzed BP characteristics of 951 elderly men, free of congestive heart failure , valvular disease, and left ventricular hypertrophy at baseline between 1990 and 1995. They followed the participants until the end of 2002. Twenty-four-hour ambulatory blood pressure monitoring was performed at baseline, and the blood pressure variables were analyzed as predictors of subsequent congestive heart failure.

Seventy men developed heart failure during follow-up. In analysis adjusted for antihypertensive treatment and established risk factors for congestive heart failure ( myocardial infarction, diabetes, smoking, body mass index, and serum cholesterol level ), a 9–mm Hg increase in nighttime ambulatory diastolic blood pressure and the presence of "nondipping" blood pressure ( BP that is at least as high at night as during the day ) were associated with an increased risk of congestive heart failure. Nighttime ambulatory diastolic blood pressure and nondipping blood pressure were also significant predictors of congestive heart failure after excluding all participants who had a myocardial infarction before baseline or during follow-up.

Furthermore, a nondipping nighttime BP pattern increased the risk of congestive heart failure even after adjusting for conventional office BP measurement. " This indicates that nighttime BP patterns may be important in development of congestive heart failure and that a traditional office BP measurement does not capture all of the increased risk that an increased nighttime blood pressure conveys," the authors write.

" Nighttime blood pressure appears to convey additive risk information about congestive heart failure, but its clinical value remains to be established in future studies."

Source: Journal of American Medical Association, 2006


XagenaMedicine2006



Link: Xapedia - Medical Encyclopedia