Increased nighttime blood pressure may be linked to higher risk for congestive heart failure

June 27, 2006

Having a relatively high blood pressure level at night may increase the risk for congestive heart failure, according to a study in the June 28 issue of JAMA.

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, according to background information in the article. The death rate associated with CHF exceeds that of most cancers, although recent reports suggest an improving prognosis. The predominant causes of CHF 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) BP as a predictor of CHF in persons free of CHF at baseline.

Erik Ingelsson, M.D., Ph.D., of Uppsala University, Uppsala, Sweden, and colleagues analyzed BP characteristics of 951 elderly men, free of CHF, 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 CHF.

Seventy men developed heart failure during follow-up. In analysis adjusted for antihypertensive treatment and established risk factors for CHF (heart attack, 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 CHF. Nighttime ambulatory diastolic blood pressure and nondipping blood pressure were also significant predictors of CHF after excluding all participants who had a heart attack before baseline or during follow-up.

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

"Nighttime BP appears to convey additive risk information about CHF, but its clinical value remains to be established in future studies."
-end-
(JAMA. 2006;295:2859-2866. Available pre-embargo to the media at www.jamamedia.org)

Editor's Note: Funding was provided by Primary Health Care in Uppsala County, the Swedish Heart Lung Foundation (Hjärt-Lungfonden), and the Thuréus Foundation. Co-author Lars Lind, M.D., Ph.D., is a part-time employee at AstraZeneca Research and Development, Mölndal, Sweden, and a part-time employee at Uppsala University (AstraZeneca has no interests in this project and has not provided any financial support). No other disclosures were reported.

The JAMA Network Journals

Related Blood Pressure Articles from Brightsurf:

Children who take steroids at increased risk for diabetes, high blood pressure, blood clots
Children who take oral steroids to treat asthma or autoimmune diseases have an increased risk of diabetes, high blood pressure, and blood clots, according to Rutgers researchers.

High blood pressure treatment linked to less risk for drop in blood pressure upon standing
Treatment to lower blood pressure did not increase and may decrease the risk of extreme drops in blood pressure upon standing from a sitting position.

Changes in blood pressure control over 2 decades among US adults with high blood pressure
National survey data were used to examine how blood pressure control changed overall among U.S. adults with high blood pressure between 1999-2000 and 2017-2018 and by age, race, insurance type and access to health care.

Transient increase in blood pressure promotes some blood vessel growth
Blood vessels are the body's transportation system, carrying oxygen and nutrients to cells and whisking away waste.

Effect of reducing blood pressure medications on blood pressure control in older adults
Whether the amount of blood pressure medications taken by older adults could be reduced safely and without a significant change in short-term blood pressure control was the objective of this randomized clinical trial that included 534 adults 80 and older.

Brain blood flow sensor discovery could aid treatments for high blood pressure & dementia
A study led by researchers at UCL has discovered the mechanism that allows the brain to monitor its own blood supply, a finding in rats which may help to find new treatments for human conditions including hypertension (high blood pressure) and dementia.

Here's something that will raise your blood pressure
The apelin receptor (APJ) has been presumed to play an important role in the contraction of blood vessels involved in blood pressure regulation.

New strategy for treating high blood pressure
The key to treating blood pressure might lie in people who are 'resistant' to developing high blood pressure even when they eat high salt diets, shows new research published today in Experimental Physiology.

Arm cuff blood pressure measurements may fall short for predicting heart disease risk in some people with resistant high blood pressure
A measurement of central blood pressure in people with difficult-to-treat high blood pressure could help reduce risk of heart disease better than traditional arm cuff readings for some patients, according to preliminary research presented at the American Heart Association's Hypertension 2019 Scientific Sessions.

Heating pads may lower blood pressure in people with high blood pressure when lying down
In people with supine hypertension due to autonomic failure, a condition that increases blood pressure when lying down, overnight heat therapy significantly decreased systolic blood pressure compared to a placebo.

Read More: Blood Pressure News and Blood Pressure Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.