Nocturnal hypertension tied to poorer cardiovascular outcomes among seniors

Among patients of very advanced age, those with nocturnal hypertension are at increased risk of adverse cardiovascular outcomes, as reported in a study.

The study included 485 Japanese outpatients aged ≥80 years (median age 82 years, 44.7 percent male), of which 89.3 percent were taking antihypertensive medications. All of them underwent 24-h ambulatory BP monitoring at baseline. Nocturnal hypertension was defined as nocturnal systolic BP ≥120 mm Hg and diastolic BP ≥70 mm Hg. Daytime hypertension was defined as daytime systolic BP ≥135 mm Hg and diastolic BP ≥85 mm Hg.

A total of 72 (14.8 percent) composite cardiovascular outcomes (fatal and nonfatal) occurred over a median follow-up of 3.9 years (1,734 person-years). More than half of the patients (54.2 percent) had nocturnal hypertension, and 33.6 percent had daytime hypertension.

Compared nocturnal normotension (nocturnal systolic BP <120 mm Hg and diastolic BP <70 mm Hg), nocturnal hypertension was associated with a more than twofold increased risk of composite cardiovascular outcomes, even after adjustment for daytime BP values (adjusted hazard ratio, 2.15, 95 percent confidence interval, 1.18–3.93).

Daytime hypertension showed no association with cardiovascular outcomes.

The findings underscore the importance of screening for nocturnal hypertension to identify a high-risk group for composite cardiovascular outcomes among patients of very advanced age.