The researches find that higher daytime and nighttime systolic blood pressure (SBP) is associated with an increased risk for cardiovascular disease (CVD) events and all-cause mortality independent of blood pressure (BP) levels measured in the clinic, according to a study published online Aug. 14 in JAMA Cardiology. Yuichiro Yano, M.D., Ph.D., from Duke University in Durham, North Carolina; and colleagues used data from 1,034 African-American participants (mean age, 58.9 years; 32.6 percent male) in the Jackson Heart Study who completed ambulatory BP monitoring at baseline (Sept. 26, 2000, to March 31, 2004).

Nighttime systolic blood pressure

The researchers found that the mean daytime SBP/diastolic BP (DBP) was 129.4/77.6 mm Hg, and the mean nighttime SBP/DBP was 121.3/68.4 mm Hg. During a median of 12.5 years of follow-up for CVD and 14.8 years for all-cause mortality, there were 113 CVD events and 194 deaths. But Adjusting for in-clinic SBP and DBP, for each standard deviation (SD) higher level of BP; the hazard ratios (HRs) for CVD events were 1.53 (95% confidence interval [CI], 1.24 to 1.88) for daytime SBP (per 13.5 mm Hg), 1.48 (95% CI, 1.22 to 1.80) for nighttime SBP (per 15.5 mm Hg); 1.25 (95% CI, 1.02 to 1.51) for daytime DBP (per 9.3 mm Hg), and 1.30 (95% CI, 1.06 to 1.59) for nighttime DBP (per 9.5 mm Hg).

There was an association between nighttime SBP and all-cause mortality (HR per 1-SD higher level, 1.24; 95% CI, 1.06 to 1.45); but there was no association for daytime SBP (HR, 1.13; 95% CI, 0.97 to 1.33); and either daytime (HR, 0.95; 95 percent CI, 0.81 to 1.10) or nighttime (HR; 1.06; 95% CI, 0.90 to 1.24) DBP. “Measurement of daytime and nighttime BP using ambulatory monitoring during a 24-hour period may help identify African-American individuals who have an increased cardiovascular disease risk;” the authors write.

The cardiovascular system

Cardiovascular disease or cardiovascular diseases refers to the class of diseases that involve the heart or blood vessels (arteries and veins). While the term technically refers to any disease that affects the cardiovascular system (as used in MeSH); it is usually use to refer to those relate to atherosclerosis (arterial disease). These conditions have similar causes, mechanisms, and treatments. In practice, cardiovascular disease is treat by cardiologists; thoracic surgeons, vascular surgeons, neurologists; and interventional radiologists; depending on the organ system that is being treated.

There is considerable overlap in the specialties, and it is common for certain procedures to be performed by different types of specialists in the same hospital. Most countries face high and increasing rates of cardiovascular disease. Each year, heart disease kills more Americans than cancer. Therefore It is the number one cause of death and disability in the United States and most European countries (data available through 2005). A large histological study (PDAY) showed vascular injury accumulates from adolescence, making primary prevention efforts necessary from childhood.