Ohashi Naoto, Sato Yu, Yoshihisa Akiomi, Takeishi Ryohei, Misaka Tomofumi, Yokokawa Tetsuro, Sato Takamasa, Oikawa Masayoshi, Kobayashi Atsushi, Nakazato Kazuhiko, Takeishi Yasuchika
Department of Cardiovascular Medicine Fukushima Medical University Fukushima Japan.
Department of Clinical Laboratory Sciences Fukushima Medical University School of Health Sciences Fukushima Japan.
J Am Heart Assoc. 2025 Aug 5;14(15):e039917. doi: 10.1161/JAHA.124.039917. Epub 2025 Jul 21.
The optimal systolic blood pressure (SBP) target for heart failure (HF) patients has not been established. Although the association between daytime SBP and prognosis has been reported in patients with HF, the prognostic impact of nighttime SBP remains unclear.
We conducted continuous nighttime SBP measurements noninvasively using pulse transit time in 366 patients with HF (median age, 72 years; male sex, 195), and followed up for cardiac events (HF hospitalization or cardiac death). Average values of nighttime pulse transit time -based SBP were used in the present study. The patients were divided into tertile groups based on nighttime pulse transit time-based SBP: high-SBP group (median SBP, 136 mm Hg; n=122), middle-SBP group (median SBP, 117 mm Hg; n=122), and low-SBP group (median SBP, 100 mm Hg; n=122).
During a median follow-up period of 1083 days after nighttime pulse transit time-based SBP measurement, 71 patients experienced a cardiac event. Kaplan-Meier analysis showed the highest incidence of cardiac events in the low-SBP group. Multivariate Cox proportional hazard analysis also showed that the lowest SBP tertile was associated with a higher risk of cardiac events compared with the highest SBP tertile as reference (hazard ratio, 2.100 [95% CI, 1.121-3.933]; =0.021).
Low nighttime SBP was associated with an increased cardiac event rate in patients with HF.
心力衰竭（HF）患者的最佳收缩压（SBP）目标尚未确定。尽管已有报道称HF患者白天SBP与预后之间存在关联，但夜间SBP对预后的影响仍不明确。
我们对366例HF患者（中位年龄72岁；男性195例）使用脉搏传输时间进行无创连续夜间SBP测量，并随访心脏事件（HF住院或心源性死亡）。本研究采用基于夜间脉搏传输时间的SBP平均值。根据基于夜间脉搏传输时间的SBP将患者分为三分位数组：高SBP组（中位SBP，136 mmHg；n = 122）、中SBP组（中位SBP，117 mmHg；n = 122）和低SBP组（中位SBP，100 mmHg；n = 122）。
在基于夜间脉搏传输时间的SBP测量后的中位随访期1083天内，71例患者发生了心脏事件。Kaplan-Meier分析显示低SBP组心脏事件发生率最高。多变量Cox比例风险分析还显示，与以最高SBP三分位数为参照相比，最低SBP三分位数与心脏事件风险较高相关（风险比，2.100 [95% CI，1.121 - 3.933]；P = 0.021）。
HF患者夜间SBP较低与心脏事件发生率增加有关。
