Supplemental Digital Content is available in the text. Whether extreme dipping is associated with cardiovascular events (CVE) is unclear. The present study was conducted to test the hypothesis that the prognostic role of extreme dipping varies as a function of age. The analysis was performed in 10 868 participants (53% men) aged 53±15 (mean±SD) years enrolled in 8 prospective studies. Using the ambulatory systolic blood pressure nocturnal decline, we identified 4 groups: dippers (>10%–20%), nondippers (>0%–10%), reverse dippers (≤0%), and extreme dippers (>20%). The association between dipping category and CVE was estimated as a function of age using Cox models adjusted for sex, average 24-hour systolic blood pressure, and traditional risk factors. During a median follow-up of 5.7 years, there were a total of 829 CVE (168 fatal). For extreme dippers, no increase in risk of CVE was observed among the participants <70 years (hazard ratio, 0.99 [95% CI, 0.73–1.34]; P=0.93) compared with dippers. In contrast, among the participants ≥70 years, there was a significant increase in risk (hazard ratio, 1.88 [95% CI, 1.14–3.11]; P=0.013). Among the octogenarians, the hazard ratio (95% CI) for CVE were 2.34 (1.12–4.93) for nondippers (P=0.024), 3.91 (1.75–8.73) for reverse dippers (P=0.001), and 4.12 (1.64–10.37) for extreme dippers (P=0.003) compared with dippers. These data show that extreme dipping is not associated with poorer outcome in people younger than 70 years. A U-shaped relationship between nocturnal blood pressure dipping and adverse outcome is present in subjects older than 70 years. In the octogenarian extreme dippers, the risk of CVEs was 4× higher than in the dippers and similar to that in the reverse dippers.

中文翻译：

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极端夜间浸渍与心血管事件的关联在很大程度上取决于年龄

补充数字内容在文本中可用。极端浸渍是否与心血管事件 (CVE) 相关尚不清楚。本研究旨在检验极端浸渍的预后作用随年龄而变化的假设。该分析是在 8 项前瞻性研究中纳入的 10 868 名参与者（53% 男性）中进行的，这些参与者年龄为 53±15（平均±标准差）岁。使用动态收缩压夜间下降，我们确定了 4 组：杓型 (>10%–20%)、非杓型 (>0%–10%)、反杓型 (≤0%) 和极端杓型 (>20%) . 使用根据性别、平均 24 小时收缩压和传统风险因素调整的 Cox 模型，将浸渍类别与 CVE 之间的关联估计为年龄的函数。在中位随访 5.7 年期间，共有 829 例 CVE（168 例死亡）。对于极端杓型，与杓型相比，未观察到 <70 岁参与者的 CVE 风险增加（风险比，0.99 [95% CI，0.73–1.34]；P=0.93）。相反，在 70 岁以上的参与者中，风险显着增加（风险比，1.88 [95% CI，1.14–3.11]；P=0.013）。在八十多岁的老人中，非杓型 (P=0.024) 的 CVE 风险比 (95% CI) 为 2.34 (1.12–4.93)，反杓型 (P=0.001) 为 3.91 (1.75–8.73) 和 4.12 (1.674–13) ) 与北斗星相比，极端北斗星 (P=0.003)。这些数据表明，在 70 岁以下的人群中，极度下垂与较差的结果无关。在 70 岁以上的受试者中，夜间血压下降与不良结果之间存在 U 型关系。在八十多岁的极端北斗七星中，