To examine relationships of extreme dipping with all-cause mortality.Design and Method:
We analyzed our database of 4842 subjects referred for ambulatory blood pressure (BP) monitoring (ABPM); 2851 treated and 1991 untreated subjects. The normal dip was defined for as 10% reduction in systolic BP (SBP) during sleep compared with the awake period. Non-dipping was defined as a decrease < 10% but ≥ 10%. Dipping beyond 20% was considered extreme. Negative dippers were defined “risers”. Patients were followed up for all-cause mortality per Ministry of Interior registry.Results:
During median of 9.8 years of follow-up (25th-75th percentile: 5.2–14.5 years), 528 of the treated (18.5%), and 133 of the untreated (6.7%) died. Cox proportional hazards ratios (HR) were calculated with 95% confidence intervals (CI), adjusted for age, gender, body mass index, 24 hour SBP, and treatment for diabetes, as shown in the table.Conclusions:
There is no mortality risk associated with extreme dipping in both treated and untreated subject, and it is similar and if anything tends to be lower than that of normal dipping.