title: Prognostic significance of dipping in older hypertensive patients.
abstract: OBJECTIVE
  Arterial hypertension doubles the risk of coronary heart disease, heart and kidney failure, and peripheral arterial disease. Less variation in diurnal ambulatory blood pressure monitoring (ABPM) patterns may affect mortality outcome. Therefore, as hypertension occurs in over 95% of older subjects, the prognostic value of dipping status in older hypertensive patients will be assessed.
  
  
  METHODS
  The retrospective study group consisted of 170 hypertensive patients, aged 75-84 years, enrolled in the years 2005 to 2007. Baseline measures included 24-h ABPM. Diurnal index and dipping status was calculated and stratified the group into dippers (40 patients, 23.5%), non-dippers (65 patients, 38.2%) and reverse-dippers (65 patients, 38.2%).
  
  
  RESULTS
  During a 5-year observation, after baseline we have observed 69 deaths (40.9%) from the whole group of 170 patients with 23 (35.4%) being non-dippers and 36 (55.4%) reverse-dippers. There were significant differences between the groups divided according to diurnal dipping status in survival time, number of recorded deaths and night mean blood pressure. We have identified and confirmed risk factors for the all-cause mortality: age, mean systolic and diastolic blood pressure, diurnal index and dipping status (dipping, non-dipping or reverse-dipping).
  
  
  CONCLUSIONS
  Reverse-dippers and non-dippers revealed worse prognosis compared with dippers.
authors: 2nd Department of Internal Medicine, Faculty of Medicine, Comenius University and University Hospital , Bratislava , Slovak Republic.
authors: Matej
authors: M
authors: Bendzala
authors: Peter
authors: P
authors: Kruzliak
authors: Ludovit
authors: L
authors: Gaspar
authors: Miroslav
authors: M
authors: Soucek
authors: Igor
authors: I
authors: Mrdovic
authors: Peter
authors: P
authors: Sabaka
authors: Andrej
authors: A
authors: Dukat
authors: Iveta
authors: I
authors: Gasparova
authors: Leoné
authors: L
authors: Malan
authors: Kenji
authors: K
authors: Takazawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors
keywords: 5-year mortality; ABPM; arterial hypertension; blood pressure dipping