This Article Full Text Full Text (PDF) All Versions of this Article: 49/4/777    most recent 01.HYP.0000258215.26755.20v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Verdecchia, P. Articles by Reboldi, G. Search for Related Content PubMed PubMed Citation Articles by Verdecchia, P. Articles by Reboldi, G. Pubmed/NCBI databases Medline Plus Health Information High Blood Pressure Related Collections Clinical Studies Epidemiology Other hypertension Other diagnostic testing Risk Factors Related Article

(Hypertension. 2007;49:777.)
© 2007 American Heart Association, Inc.

Original Articles

Ambulatory Blood Pressure and Cardiovascular Outcome in Relation to Perceived Sleep Deprivation

Paolo Verdecchia; Fabio Angeli; Claudia Borgioni; Roberto Gattobigio; Gianpaolo Reboldi

From the Struttura Complessa di Cardiologia, Unità di Ricerca Clinica–Cardiologia Preventiva, Ospedale S. Maria della Misericordia (P.V., F.A., C.B.), Ospedale Beato G. Villa, Città della Pieve (R.G.), and the Dipartimento di Medicina Interna (G.R.), Università di Perugia, Perugia, Italy.

Correspondence to Paolo Verdecchia, Struttura Complessa di Cardiologia, Unità di Ricerca Clinica–Cardiologia Preventiva, Ospedale S. Maria della Misericordia, Piazzale G. Menghini, 06132 Perugia, Italy. E-mail verdec{at}tin.it

Sleep deprivation induced by cuff inflations during overnight blood pressure (BP) monitoring might interfere with the prognostic significance of nighttime BP. In 2934 initially untreated hypertensive subjects, we assessed the perceived quantity of sleep during overnight BP monitoring. Overall, 58.7%, 27.7%, 9.7%, and 4.0% of subjects reported a sleep duration perceived as usual (group A), <2 hours less than usual (group B), 2 to 4 hours less than usual (group C), and >4 hours less than usual (group D). Daytime BP did not differ across the groups (all Ps not significant). Nighttime BP increased from group A to D (124/75, 126/76, 128/77, and 129/79 mm Hg, respectively; all Ps for trend <0.01). Over a median follow-up period of 7 years there were 356 major cardiovascular events and 176 all-cause deaths. Incidence of total cardiovascular events and deaths was higher in the subjects with a night/day ratio in systolic BP >10% compared with those with a greater day–night BP drop in the group with perceived sleep duration as usual or <2 hours less than usual (both P<0.01), not in the group with duration of sleep 2 hours less than usual (all Ps not significant). In a Cox model, the independent prognostic value of nighttime BP for total cardiovascular end points and all-cause mortality disappeared in the subjects with perceived sleep deprivation 2 hours. In conclusion, nighttime BP rises and loses its prognostic significance in the hypertensive subjects who perceive a sleep deprivation by 2 hours during overnight monitoring.

Key Words: hypertension • dippers • nondippers • blood pressure monitoring • sleep • stroke • myocardial infarction • epidemiology

Related Article:

Sleepers Versus Nonsleepers: Another Twist to the Dipper/Nondipper Concept

Eoin O’Brien
Hypertension 2007 49: 769-770. [Full Text] [PDF]

This article has been cited by other articles:

				L. Bankir, M. Bochud, M. Maillard, P. Bovet, A. Gabriel, and M. Burnier Nighttime Blood Pressure and Nocturnal Dipping Are Associated With Daytime Urinary Sodium Excretion in African Subjects Hypertension, April 1, 2008; 51(4): 891 - 898. [Abstract] [Full Text] [PDF]

				D. Martinez and F. D. Fuchs Why Is Nondipping in Ambulatory Blood Pressure Monitoring Not Prognostic in Poor Sleepers? Hypertension, August 1, 2007; 50(2): e20 - e20. [Full Text] [PDF]

				P. Verdecchia, F. Angeli, and G. Reboldi Response to Why Is Nondipping in Ambulatory Blood Pressure Monitoring Not Prognostic in Poor Sleepers? Hypertension, August 1, 2007; 50(2): e21 - e21. [Full Text] [PDF]

				E. O'Brien Sleepers Versus Nonsleepers: Another Twist to the Dipper/Nondipper Concept Hypertension, April 1, 2007; 49(4): 769 - 770. [Full Text] [PDF]