Association between nocturnal blood pressure and cardiovascular events in individuals aged ≥80 vs <80 years: the JAMP study
T Fujiwara, S Hoshide, K KarioAbstract
Background
Nocturnal blood pressure (BP) is a stronger predictor of cardiovascular disease (CVD) events than office or daytime BP. However, its clinical significance in the very elderly (≥80 years) compared with younger individuals remains unclear.
Purpose
To examine the association between nocturnal BP and CVD events in individuals aged ≥80 versus <80 years.
Methods
We analyzed data from the Japan Ambulatory Blood Pressure Monitoring Prospective (JAMP) Study, including 6,359 participants with cardiovascular risk factors (mean age 69±12 years; 52% women; 77% on antihypertensive medications). All underwent baseline 24-h ambulatory BP monitoring. Nocturnal systolic BP (SBP) was divided into quintiles, and associations with total CVD events (coronary artery disease, stroke, and heart failure) were assessed using Cox regression.
Results
During 4.5±2.4 years of follow-up, 306 CVD events occurred. In 1,046 individuals aged ≥80 years, each 10-mmHg higher nocturnal SBP was associated with greater CVD risk (HR 1.15, 95% CI 1.03–1.29), with a U-shaped relationship (Fig.). This association was not observed in those aged <80 years (HR 1.08, 95% CI 0.99–1.16).
Conclusions
The impact of nocturnal BP differed by age, showing clear prognostic value in those ≥80 years. Screening for nocturnal BP may help identify high-risk elderly individuals.Figure