The association between nocturnal blood pressure patterns and the incidence of major adverse cardiovascular events: a 5-year cohort study

This was a 5-year prospective cohort study investigating the association between nocturnal blood pressure patterns and the incidence of major cardiovascular events among 2450 residents in Tashkent, Samarkand, and Bukhara. According to the result of 24-hour blood pressure monitoring, participants were divided into three groups: dipper pattern (1,072 cases), non-dipper pattern (982 cases), and riser pattern (396 cases). They were followed up for 5 years to investigate the incidence of major cardiovascular events such as myocardial infarction, stroke, heart failure, and cardiovascular mortality. During the follow-up period, 334 major cardiac events were recorded, and the highest incidence was seen within the riser pattern at a rate of 24.7 cases per 1,000 person-years. In multivariable analysis, adjusted for age, sex, diabetes, and smoking, the relative risk of events in the riser pattern was 2.52-fold (95% CI: 1.87-3.40) and in the non-dipper pattern was 1.65-fold (95% CI: 1.25-2.18) higher than that in the dipper pattern. In addition, it was found that the risk of microalbuminuria is significantly higher in the riser group, with a relative risk of 2.37. Current findings of this study suggest that the abnormal pattern of nocturnal blood pressure, especially the riser pattern, is a strong and independent risk factor for major adverse cardiac events in the Uzbek population, and 24-hour blood pressure monitoring may play a vital role in identifying high-risk individuals.