Relation Between Nocturnal Decline in Blood Pressure and Mortality The Ohasama Study
Abstract
To investigate the relation between nocturnal decline in blood pressure and mortality, we obtained ambulatory blood pressures in 1542 residents aged 40 years or over of a rural Japanese community. Subjects were followed-up for a mean of 5.1 years and were then subdivided into four groups according to the percent decline in nocturnal blood pressure: 1) extreme dippers: percent decline in nocturnal blood pressure > or = 20% of the daytime blood pressure; 2) dippers: decline of > or = 10% but < 20%; 3) nondippers: decline of > or = 0% but < 10%; and 4) inverted dippers: no decline. The relationship between the decline in nocturnal blood pressure and mortality was examined by the Cox proportional hazards regression model adjusted for age, sex, smoking status, previous history of cardiovascular disease, and the use of antihypertensive medication. The mortality risk was highest in inverted dippers, followed by nondippers. There was no difference in mortality between extreme dippers and dippers. This relationship was observed for both treated and untreated subjects, was more pronounced for cardiovascular than for noncardiovascular mortality, and did not change after the data were adjusted for 24-h, daytime, and nighttime blood pressure levels.
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Blood pressure is usually lower in sleep than in wakefulness and has a characteristic surge after awakening.
“BP is usually lower in sleep than in wakefulness and has a characteristic surge after awakening, drawing parallels with the daily pattern of adverse CV events (refs.94-97 and Figure 1).”
From Role of the circadian system in cardiovascular disease (2018) · cites this paper as [96]
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- Authors
- Ohkubo, T.
- Affiliations
- Tohoku University (JP)
- Corresponding author
- Ohkubo, T
- ORCID
- Ohkubo, T
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 1997-11
- Volume
- 10
- Issue
- 11
- Pages
- 1201-1207
- ISSN
- 0895-7061 (ISSN-L)
- OpenAlex
- W2156052378
- Cited by
- 491
- References
- 31
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 8 · 2023: 16 · 2022: 20 · 2021: 19 · 2020: 14 · 2019: 17 · 2018: 19 · 2017: 12 · 2016: 19 · 2015: 21 · 2014: 20 · 2013: 20 · 2012: 24
- FWCI
- 5.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Keywords
- nocturnal blood pressure dipping, non-dippers, ambulatory blood pressure, mortality, cardiovascular mortality, hypertension, antihypertensive drugs, Ohasama study
- MeSH terms
- Aged, Antihypertensive Agents, Blood Pressure, Circadian Rhythm, Female, Humans, Hypertension, Japan, Longitudinal Studies, Male, Middle Aged, Prognosis, Prospective Studies, Smoking, Proportional Hazards Models, Blood Pressure Monitoring, Ambulatory
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