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Nighttime Blood Pressure May Predict Heart Failure

Failure of nighttime pressure to drop doubles heart failure risk

WEDNESDAY, June 28 (HealthDay News) -- Elderly men with a nighttime blood pressure that stays the same or increases compared with the daytime pressure have more than twice the risk of developing heart failure, according to a report in the June 28 issue of the Journal of the American Medical Association.

Erik Ingelsson, M.D., Ph.D., of Uppsala University in Sweden, and colleagues examined the association between 24-hour ambulatory blood pressure and congestive heart failure in 951 elderly men who were free of congestive heart failure, valvular disease and left ventricular hypertrophy between 1990 and 1995.

In 2002, the researchers found that 70 men had developed heart failure. After adjusting for antihypertensive treatment and established risk factors, they found that those with an increased risk of developing heart failure had a 9-mm Hg increase in nighttime ambulatory diastolic blood pressure (hazard ratio 1.26) and the presence of "non-dipping" blood pressure (hazard ratio 2.29). A non-dipping nighttime blood pressure remained a significant predictor of congestive heart failure after adjusting for office-measured blood pressure as well as after excluding patients with a previous myocardial infarction.

"Nighttime blood pressure appears to convey additional risk information about congestive heart failure beyond office-measured blood pressure and other established risk factors for congestive heart failure," the authors conclude.

One of the researchers was employed by AstraZeneca Research and Development in Sweden.

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