Blood pressure dipping patterns have long been considered to be associated with adverse events. We aimed to investigate whether dipping patterns of postoperative MAP were related to 90-day and hospital mortality in patients undergoing CABG. Four thousand three hundred ninety-one patients were classified into extreme dippers (night-to-day ratio of MAP ≤ 0.8), dippers (0.8 < night-to-day ratio of MAP ≤ 0.9), non-dippers (0.9 < night-to-day ratio of MAP ≤ 1), and reverse dippers (> 1). Compared with non-dippers, reverse dippers were at a higher risk of 90-day mortality (aHR = 1.58; 95% CI, 1.10–2.27) and hospital mortality (aOR = 1.97; 95% CI, 1.12–3.47). A significant interaction was observed between hypertension and dipping patterns (P for interaction = 0.02), with a significant increased risk of 90-day mortality in non-hypertensive reverse dippers (aHR = 1.90; 95% CI, 1.17–3.07) but not in hypertensive reverse dippers (aHR = 1.26; 95% CI, 0.73–2.19).

Graphical Abstract

Patients with the reverse dipping pattern have a higher risk of 90-day mortality after receiving CABG, while the association between dipping patterns and mortality was moderated by hypertension.

中文翻译：

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冠状动脉搭桥术后平均动脉压和死亡率的下降模式

长期以来，血压下降模式一直被认为与不良事件有关。我们的目的是调查术后 MAP 的下降模式是否与接受 CABG 的患者 90 天死亡率和医院死亡率相关。将 4,391 名患者分为极端杓型（MAP 夜间与白天比率 ≤ 0.8）、杓型（0.8 < MAP 夜间与白天比率 ≤ 0.9）、非杓型（0.9 < 夜间）。 MAP ≤ 1 的日比），以及反向七星 (> 1)。与非杓型相比，反向杓型的 90 天死亡率（aHR = 1.58；95% CI，1.10–2.27）和医院死亡率（aOR = 1.97；95% CI，1.12–3.47）风险更高。在高血压和倾斜模式之间观察到显着的交互作用（交互作用P = 0.02），非高血压反向倾斜模式的 90 天死亡率显着增加（aHR = 1.90；95% CI，1.17-3.07），但在非高血压反向倾斜模式中则没有显着增加。高血压反杓型（aHR = 1.26；95% CI，0.73–2.19）。

图形概要

具有反向浸渍模式的患者在接受 CABG 后 90 天死亡的风险较高，而浸渍模式与死亡率之间的关联受到高血压的调节。