{"id":"1731f587045d","type":"article","url":"https://hartvaat.nl/2016/04/01/prognostisch-effect-van-nachtelijke-bloeddrukdaling-bij-hypertensie-de-abc-h-stu/","title":"Prognostisch effect van nachtelijke bloeddrukdaling bij hypertensie: de ABC-H-studie","title_en":"Prognostic Effect of the Nocturnal Blood Pressure Fall in Hypertensive Patients: The Ambulatory Blood Pressure Collaboration in Patients With Hypertension (ABC-H) Meta-Analysis.","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog","huisarts","internist"],"tags":["bloeddrukbehandeling","nt-probnp"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.115.06981","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.115.06981","authors":["Gil F Salles","Gianpaolo Reboldi","Robert H Fagard","Claudia R L Cardoso","Sante D Pierdomenico","Paolo Verdecchia","Kazuo Eguchi","Kazuomi Kario","Satoshi Hoshide","Jorge Polonia","Alejandro de la Sierra","Ramon C Hermida","Eamon Dolan","Eoin O'Brien","George C Roush"],"significance":6,"published":"2016-04-01","source_date":"2016-04-01","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/bloeddrukmeting-thuismeting-abpm/","https://hartvaat.nl/kennis/hypertensie/hypertensie-en-ckd/"],"congress":"","summary_en":"This multicenter study evaluated the prognostic significance of the nocturnal blood pressure fall pattern (dipping) using ambulatory monitoring, showing that non-dipping independently predicts cardiovascular events after adjusting for 24-hour blood pressure.","created":"2026-07-03T10:26:01Z","updated":"2026-07-03T18:38:23Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Multicenter studie naar het prognostisch belang van het nachtelijke bloeddrukdalingspatroon (dipping) bij hypertensieve patiënten middels ambulante bloeddrukmeting. Non-dippers hebben een verhoogd cardiovasculair risico.","abstract_original":"The prognostic importance of the nocturnal systolic blood pressure (SBP) fall, adjusted for average 24-hour SBP levels, is unclear. The Ambulatory Blood Pressure Collaboration in Patients With Hypertension (ABC-H) examined this issue in a meta-analysis of 17 312 hypertensives from 3 continents. Risks were computed for the systolic night-to-day ratio and for different dipping patterns (extreme, reduced, and reverse dippers) relative to normal dippers. ABC-H investigators provided multivariate adjusted hazard ratios (HRs), with and without adjustment for 24-hour SBP, for total cardiovascular events (CVEs), coronary events, strokes, cardiovascular mortality, and total mortality. Average 24-hour SBP varied from 131 to 140 mm Hg and systolic night-to-day ratio from 0.88 to 0.93. There were 1769 total CVEs, 916 coronary events, 698 strokes, 450 cardiovascular deaths, and 903 total deaths. After adjustment for 24-hour SBP, the systolic night-to-day ratio predicted all outcomes: from a 1-SD increase, summary HRs were 1.12 to 1.23. Reverse dipping also predicted all end points: HRs were 1.57 to 1.89. Reduced dippers, relative to normal dippers, had a significant 27% higher risk for total CVEs. Risks for extreme dippers were significantly influenced by antihypertensive treatment (P<0.001): untreated patients had increased risk of total CVEs (HR, 1.92), whereas treated patients had borderline lower risk (HR, 0.72) than normal dippers. For CVEs, heterogeneity was low for systolic night-to-day ratio and reverse/reduced dipping and moderate for extreme dippers. Quality of included studies was moderate to high, and publication bias was undetectable. In conclusion, in this largest meta-analysis of hypertensive patients, the nocturnal BP fall provided substantial prognostic information, independent of 24-hour SBP levels."}