What is the better preditive power for outcome: sistolic dip or diastolic dip?

• Grant number: 21/13770-5
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: March 01, 2022
• End date: February 28, 2023
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Luis Cuadrado Martin
• Grantee: Mateus de Carvalho Gonçalves
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil

Abstract

Among the blood pressure (BP) measurement modalities ambulatory blood pressure monitoring (ABPM) is the good standard, a method able to measure BP both during wakefulness and sleep. The reduction in blood pressure during sleep in relation to pressure during weakness is called nocturnal dipping, and the presence of this factor is indicative of a good prognosis. There are few studies that assess which of the falls, whether the systolic blood pressure (SBP) or the diastolic (DBP), discriminates more precisely for the future occurrence of clinical outcomes. The Brazilian ABPM guidelines recommend describing separately DBP dip and SBP dip and consider the level of evidence for this recommendation as "D", that is, an opinion devoid of critical assessment. Therefore, this study aims to understand which dip, the SBP, the DBP, or both, has the best discriminatory power for the occurrence of adverse events. Materials and methods. A retrospective cohort study that will evaluate a group of patients who underwent ABPM at the Hospital das Clínicas of the Faculdade de Medicina de Botucatu between 27/01/2004 and 16/02/2012. These patients will be followed up until the occurrence of the primary outcome (death from any cause) or until the end of the follow-up period (30/11/2019). Patients will be classified as present or absent, according to systolic pressure and later reclassified according to diastolic pressure dip. Cox curves will be drawn, which will verify which of the classification methods, whether by SBP or DBP, will be able to better distinguish the occurrence of fatal clinical outcomes.(AU)