Sleep BP predicts CVD incidence

Sleep blood pressure (BP), measured using a home BP monitor, is independently associated with the incidence of cardiovascular disease (CVD), according to a study. 

Overall, 117 CVD cases occurred in the study population comprising 5,814 community residents during a mean follow-up of 7.3 years. 

Sleep BP (per 10 mm Hg; hazard ratio [HR], 1.31; p<0.001) remained significantly associated with CV events (HR, 1.22; p=0.036) even after adjusting for office BP and confounding factors, such as sleep-disordered breathing. 

People with sleep-only hypertension (n=1,047; HR, 2.23; p=0.005) were at increased CVD risk. Similarly, daytime-only hypertension (n=264; HR, 3.57; p=0.001) and combined sleep and daytime hypertension (n=1,216; HR, 3.69; p<0.001) significantly correlated with CV events. 

On the other hand, sleep BP dipping showed no significant association with CV events. 

In this study, participants slept with wrapping cuffs on their upper arm, which measured their BP automatically at 00:00, 02:00, and 04:00. Actigraph was used to determine BP measured during sleep. Participants also had measurements of home morning and evening BP manually using the same device. 

“Nocturnal BP is associated with CVD independently of awake BP,” the researchers said. “However, nocturnal BP measured using an ambulatory monitoring device has limited reproducibility because it is a single-day measurement.”