Association of Diurnal Blood Pressure Pattern With Risk of Hospitalization or Death in Men With Heart Failure

Shin, Jaekyu; Kline, Sharoen E.; Moore, Mariellen J.; Gong, Yan; Bhanderi, Viralkumar K.; Schmalfuss, Carsten; Johnson, Julie A.; Schofield, Richard S.

doi:10.1016/j.cardfail.2007.04.013

Cited by 32 publications

(21 citation statements)

References 37 publications

(7 reference statements)

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“…This is not consistent with the previous report in which the riser BP pattern was associated with adverse outcome in HFrEF. 8 This difference can be explained by the difference in HF severity. The percentage of NYHA III/IV HF patients in that study was greater than in the present study.…”

Section: Discussionmentioning

confidence: 99%

“…7 Although a single report showed that the riser BP pattern was associated with adverse prognosis in HFrEF patients, 8 the clinical significance of abnormal circadian BP rhythm has not been established in patients with HF. Thus, we tested the hypothesis that the riser BP pattern is associated with adverse outcome in HF patients, especially those with HFpEF, by conducting an analysis of the database of the updated hospital HF cohort at Jichi Medical University Hospital.…”

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confidence: 99%

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Riser Pattern Is a Novel Predictor of Adverse Events in Heart Failure Patients With Preserved Ejection Fraction

Komori

Eguchi

Saito

et al. 2017

Circ J

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Background:The cardiovascular prognosis of heart failure with preserved ejection fraction (HFpEF) has been shown to be similar to that of heart failure with reduced ejection fraction (HFrEF). It is unknown which factors predict cardiovascular outcome in HFpEF. We tested the hypothesis that the abnormal pattern of circadian blood pressure (BP) rhythm known as the riser BP pattern is associated with adverse outcomes in HFpEF. Methods and Results:We performed a prospective, observational cohort study of hospitalized HF patients who underwent ambulatory BP monitoring (ABPM). Five hundred and sixteen hospitalized HF patients (age, 69±13 years; male, n=321 [62%]; female, n=195 [38%]) were followed up for a median 20.9 months. The composite outcome consisting of all-cause mortality and cardiovascular events was observed in 220 patients. On Kaplan-Meier analysis, the riser BP pattern subgroup had a significantly higher incidence of the composite outcome than the other subgroups of HFpEF patients (HR, 3.01; 95% CI: 1.54-6.08, P<0.01), but not the HFrEF patients. Conclusions:The riser BP pattern was found to be a novel predictor of cardiovascular outcome in HFpEF patients.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Riser Pattern Is a Novel Predictor of Adverse Events in Heart Failure Patients With Preserved Ejection Fraction

Komori

Eguchi

Saito

et al. 2017

Circ J

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“…Pronounced circadian variation has been demonstrated for CPE occurrence and a casual relationship with hypertension, particularly with nondipper/riser profile and with the presence of excessive morning surge. (22,23) Moreover, our results indicate that the chronobiological approach may be considered even beyond the horizon of the twenty four hour cycle. Although the causal relationship between gravitational interaction between the Earth and the Moon and the occurrence of CPE has not been detected so far, it is easy to automatically calculate the periods with increased risk of CPE occurrence in advance.…”

Section: Discussionmentioning

confidence: 69%

Impact of gravitational interaction between the Moon and the Earth on the occurrence of episodes of cardiogenic pulmonary edema in the field

2017

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While circadian variation of occurrence of cardiovascular emergencies has been described, it has not been assessed whether fluctuations of gravitational interaction between the Earth and the Moon may induce other types of its variation in time have the similar impact. Therefore, we decided to evaluate whether there is an association between the occurrence of prehospital cardiogenic pulmonary edema (CPE) episodes treated by Emergency Medical Services (EMS) and fluctuations in the intensity of gravitational interaction between the Earth and the Moon. Methods. We extracted all dispatches to CPE episodes from the EMS database of the Central Bohemian Region, Czech Republic, between 2.11.2008 and 1.7.2014. For each episode, the intensity of gravitational interaction between the Moon and the Earth was calculated. The study period was divided into 11 sections of equal duration according to the different intensity of gravitational interaction, and occurrence of CPE was compared among the groups. Results. We observed up to 4,744 episodes of CPE during the study period. Occurrence of CPE episodes was highest in the periods with the weakest intensity of gravitational interaction (≤1.80e1026 N), while in the periods of the most intense gravitational interaction (≥2.26e1026 N), the lowest proportion of CPE cases was observed (23.44 vs. 3.79 %, p <0.001). Conclusions. We identified a significant association between the intensity of gravitational interaction between the Earth and the Moon and occurrence of CPE, treated by our EMS. The weakest intensity was associated with its increased occurrence and vice versa. Further research is required for potential use of this phenomenon in a chronotherapeutic approach to secondary prevention of CPE.

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“…In addition, the serum creatinine level and the 24 h U-NE level were independent determinants of nighttime BP decline. Although the abnormal circadian BP pattern was reported as a prognostic predictor in the general population or in patients with hypertension or ischemic heart disease [10,11,12,22,23], to our knowledge, this is the first report of the prognostic value of circadian BP profile in patients with NIDCM.…”

Section: Discussionmentioning

confidence: 97%

Abnormal Circadian Blood Pressure Profile as a Prognostic Marker in Patients with Nonischemic Dilated Cardiomyopathy

Sawamura

Okumura²,

Takeshita³

et al. 2016

Cardiology

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Objectives: An abnormal circadian blood pressure (BP) profile is considered a risk factor for cardiovascular disease. However, its significance in heart failure patients with nonischemic etiology is unknown. Herein, we investigated the prognostic value of a circadian BP profile in patients with nonischemic dilated cardiomyopathy (NIDCM). Methods: We enrolled 114 NIDCM patients (76 males, mean age 53.1 years). The percent nighttime BP fall (%NBPF) was defined using ambulatory BP monitoring as a percent decrease in mean systolic BP in nighttime from daytime. All patients were divided into three groups: dipper (%NBPF ≥10), non-dipper (0 ≤ %NBPF < 10), and riser (%NBPF <0). Results: Riser patients had the highest serum creatinine levels (dipper, 0.78 ± 0.20 mg/dl; non-dipper, 0.85 ± 0.21 mg/dl; riser, 0.99 ± 0.23 mg/dl; p = 0.006). In survival analysis, riser patients had the highest cumulative cardiac-related deaths (log-rank, p = 0.001), which was an independent predictor of cardiac-related deaths (hazard ratio, 12.6; 95% confidence interval, 1.76-253; p = 0.01). Multivariate analysis revealed that the norepinephrine level at 24-hour collected urine (24 h U-NE) and the serum creatinine level were independent determinants of %NBPF (adjusted R² = 0.20; 24 h U-NE, p = 0.0001; serum creatinine, p = 0.04). Conclusions: The riser profile was associated with poor prognosis of NIDCM, which may reflect impaired sympathetic nervous system activity. Evaluating the circadian BP profile may be useful for risk stratification in NIDCM patients.

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Association of Diurnal Blood Pressure Pattern With Risk of Hospitalization or Death in Men With Heart Failure

Abstract: In addition to other traditional predictors, BP dipping status may be an important prognostic factor in HF.

Cited by 32 publications

References 37 publications

Riser Pattern Is a Novel Predictor of Adverse Events in Heart Failure Patients With Preserved Ejection Fraction

Riser Pattern Is a Novel Predictor of Adverse Events in Heart Failure Patients With Preserved Ejection Fraction

Impact of gravitational interaction between the Moon and the Earth on the occurrence of episodes of cardiogenic pulmonary edema in the field

Abnormal Circadian Blood Pressure Profile as a Prognostic Marker in Patients with Nonischemic Dilated Cardiomyopathy

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