Abstract 16605: Differential Impact of Nighttime Home Blood Pressure on Between Patients With and Without Subclinical Heart Failure

Abstract

Introduction: Nighttime blood pressure (BP) has stronger association with cardiovascular events than office BP, 24-hr BP, and awake BP. However, it was not clear whether the impact of nighttime BP is different for patients with or without heart failure (HF). Hypothesis: Nighttime home BP has stronger association with cardiovascular events in patients with HF. Methods: We analyzed the data from the Japan Morning Surge-Home Blood Pressure study with NT-proBNP and nighttime home BP measurement. We enrolled 2494 patients who had at least one cardiovascular risk factor. Morning, evening, and nighttime home BP were measured and cardiovascular events were followed up. Results: During 7.1 years follow-up, 168 events occurred. When NT-proBNP of 125pg/ml was used as cutoff, the patients with NT-proBNP>125pg/ml was higher daytime home SBP and nighttime home SBP than the patients with NT-proBNP≤125pg/ml (137±16 vs 132±13 mmHg, p<0.01, 126±18 vs 120±14 mmHg, p<0.01, respectively). In Cox regression analysis adjusting for significant covariates, daytime and nighttime home SBP were significant predictor for the outcome in the patients with NT-proBNP>125pg/ml (HR 1.02, 95%CI:1.01-1.03, p<0.01, HR 1.02, 95%CI:1.00-1.03, p=0.045, respectively). On the other hands, only nighttime home SBP was remained as a predictor for the outcome in the patients with NT-proBNP≤125pg/ml (HR 1.02, 95%CI:1.00-1.03, p=0.01). Conclusions: Nighttime home BP was associated with prognosis in patients with and without subclinical HF. Daytime home BP was associated with prognosis in patients with subclinical HF but not in the without subclinical HF.