LAUSR

Objective: Background In 2010 authors publish that non dipper pattern of systolic blood pressure was an heterogenous division, Bastos et al, 2010 Jul 1;12(7). We updated our population in terms of events and follow up and reanaylised. Design and method: An hypertensive population n = 1200 (645 women), ageing 51 ± 12 years, BMI 27 ± 5 Kg/m2, 53% under antihypertensive medication and without previous CV events were followed during 12.8 ± 5.1years. There were 251 CV fatal/non-fatal events (147 strokes, 67 coronary, 37 others CV). Systolic blood pressure dipping (SBPD) can be analysed has a variable continuous or a has a dipping pattern (extreme dippers < 0.8 (ED)n = 76, normal dippers < 0.9 (D)n = 514, non-dippers > 0.9 < 1.0 (ND) n = 525 and reverse dippers > 1.0 (RD)n = 83). Results: When we analysed ND patttern we found it heterogenous. ND was divided in ND1 (>0.9 < 0,95) n = 207 and ND2 (>0,95 < 1) n = 312. In a Kaplan Meier curve analysis free of CV events there were a worst survival for those ND1 compared to ND2 (log rank 5,6 p < 0.02) for Stroke (AVC) (log rank 5,3 p < 0.05). When SBPD were analysed including ND1 and ND2 in Kaplan Meier survival curves free of events RD > ND1 > ND2 > D > ED had worst CV events survival (log rank 26,9 p < 0.000),Stroke (log rank 18,7 p < 0,01), CV death (log rank 30,7 p < 0,000) global mortality (log rank 14,1 p < 0,01). ND1 has a similar behaviour has RD and ND2 has D. In a multivariate Cox analysis, adjusted to age, gender, OBP, diabetes, BMI, CV therapy, SBPD including ND1 and ND2, was predictive of CV events (HR 0.87 (IC 0,77–0,99;p < 0,05) and CV death 0,65 (IC 0,43–0,98;p < 0,05). Conclusions: In a Portuguese population, non dipping pattern is heterogenous and dividing it in ND1 and ND2 became more predictive of CV, Stroke, CV deaths and global deaths. Perhaps it's time to look for the non dipping pattern and redefine it in ND1 and ND2 for a more precise CV prognosis.