Study Finds Abnormal Levels of Blood Pressure While Asleep Increase Risk of Heart Disease
People experiencing high blood pressure while asleep are more likely to develop cardiovascular disease later, specifically heart failure, even when their blood pressure during daytime is within normal ranges.
This new finding was published today in Circulation, the flagship journal of the American Heart Association.
Reports on the study indicate that usually, health care professionals use "in-office and daytime blood pressure measurements" to identify the medication needs and dosages of a patient with hypertension.
Nonetheless, the study also specifies that a lot of patients may have "undetected nocturnal hypertension," an occurrence of high blood pressure while sleeping.
According to the study's lead author, Kazuomi Kario, MD, Ph.D., and a cardiovascular medicine professor at Jichi Medical Univesity Tochigi in Japan, nighttime blood pressure is progressively being recognized as an indicator of cardiovascular risk.
Kario also said their study provides much more extensive information on the cardiovascular risk linked to high nighttime blood pressure and different phenotypes of nighttime blood pressure than have been previously reported.
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The JAMP study signed up more than 6,000 patients from across Japan from between 2009 and 2017 and gauged levels for daytime and nighttime through the use of an at-home, wearable, ambulatory monitor.
More than 6,000 Patients Studied
The Japan Ambulatory Blood Pressure Monitoring Prospective or JAMP study signed up more than 6,000 patients from across Japan from between 2009 and 2017 and gauged levels for daytime and nighttime through the use of an at-home, wearable, ambulatory monitor.
In their research, the study authors wrote, blood pressure was gauged during daily activities, as well as asleep for at least 24 hours at a time, and "device data were occasionally downloaded at a health care clinic."
Nearly 50 percent of the study participants were male participants, and more than half were aged more than 65 years. All patients had at least one cardiovascular risk factor, and about 75 percent of them were taking medications for blood pressure. No one experienced symptomatic cardiovascular disease during the onset of the study.
Participants of the study were told to rest or sleep during nighttime and maintain their regular activities in the daytime. Their everyday activities, as well as their sleep and wake times, were self-reported through the use of a diary.
Almost every participant was able to record 20 daytime and seven nighttime automated measurements for their blood pressure.
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Increased Levels During Sleep
Increased levels, while asleep, a systolic blood pressure that measures 20 mm Hg above the daytime systolic reading of a person, was substantially linked to the risk of atherosclerotic CVD and heart failure.
The study volunteers had an abnormal circadian pattern. Sleep blood pressure goes beyond daytime readings, was at specific risk of developing heart failure, and had a higher risk of suffering from any CVD occurrences.
Excessive drop in blood pressure during sleep may be detrimental, too. The research specified, patients who had well-controlled hypertension presented a considerably increased risk of stroke "when nighttime systolic pressure took extreme dips."
Commenting on their study, Kario said, study findings indicate that "nighttime systolic blood pressure was a substantial, independent risk factor" for cardiovascular occurrences.
Nighttime Blood Pressure Monitoring
The study underscores the essentiality of including nighttime blood pressure monitoring inpatient management strategies and will hopefully inspire those in medical practice to guarantee that antihypertensive treatment is efficiently lowering blood pressure throughout a dosing period of 24 hours.
The study investigators noted that their work was not without limitations. Ambulatory data were gathered once at the beginning of the study. However, there was no available information on the contributions of succeeding changes in ambulatory blood pressure levels up until a cardiac event's diagnosis.
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Nov 03, 2020 08:00 AM EST
