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January 24, 2026Hypertension

Nocturnal Hypertension and Prognosis in Patients of Very Advanced Age

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Why the study?

Nocturnal blood pressure predicts outcomes better than daytime blood pressure, but the clinical significance of nocturnal hypertension in patients of very advanced age remains unexplored.

Does nocturnal hypertension increase the risk of composite cardiovascular outcomes in elderly outpatients aged ≥80 years?

Population

485 Japanese elderly outpatients aged ≥80 years

Comparison

Nocturnal hypertension vs nocturnal normotension

Design

Prospective observational study

Follow-up

Median 3.9 years

Key result

Nocturnal hypertension in patients aged ≥80 years was associated with a 2.15-fold increased risk of composite cardiovascular outcomes compared to nocturnal normotension.

Authors

TFTakeshi FujiwaraSHSatoshi HoshideKKKazuomi Kario

Discussion

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Member takes

Overview

May inform risk stratification via ambulatory monitoring in octogenarians; leaves open whether treating nocturnal hypertension improves outcomes.

Key Points

  • Assess the link between nocturnal hypertension and cardiovascular outcomes in very elderly patients.
  • Prospective observational study of Japanese outpatients aged 80 and older
  • 24-hour ambulatory blood pressure monitoring for baseline measurement
  • Defined nocturnal hypertension as nocturnal systolic BP ≥120 mm Hg
  • Used Cox regression analysis to examine associations with cardiovascular outcomes
  • 72 composite cardiovascular outcomes occurred over a median follow-up of 3.9 years
  • Nocturnal hypertension present in 54.2% of patients, associated with a hazard ratio of 2.15 for outcomes
  • Daytime hypertension did not show a similar association with outcomes

Structured PICO

Does nocturnal hypertension increase the risk of composite cardiovascular outcomes in elderly outpatients aged ≥80 years?

P
Population
485 Japanese elderly outpatients aged ≥80 years (median age 82, 44.7% male), with 89.3% taking antihypertensive medications.
I
Intervention
Nocturnal hypertension (defined as nocturnal systolic BP ≥120 mm Hg and diastolic BP ≥70 mm Hg on 24-hour ambulatory BP monitoring)
C
Comparator
Nocturnal normotension (nocturnal systolic BP <120 mm Hg and diastolic BP <70 mm Hg)
O
Outcome
Composite cardiovascular outcomes (fatal and nonfatal cardiovascular disease and all-cause mortality)composite

Nocturnal hypertension, but not daytime hypertension, is a significant predictor of cardiovascular events and mortality in patients aged 80 years and older.

Cite This Study

Fujiwara et al. (2026) studied this question. Nocturnal hypertension in patients aged ≥80 years was associated with a 2.15-fold increased risk of composite cardiovascular outcomes compared to nocturnal normotension.

synapsesocial.com/papers/6974610cbb9d90c67120af55https://doi.org/10.1161/hypertensionaha.125.25199
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