Palatini P, Verdecchia P, Beilin LJ, et al. - Researchers sought to determine if extreme dipping is associated with cardiovascular events (CVE) and to test if the prognostic role of extreme dipping varies as a function of age. Division of 10,868 participants (53% men) aged 53±15 (mean±SD) years enrolled in 8 prospective studies into 4 groups was done using the ambulatory systolic blood pressure nocturnal decline: dippers (> 10%–20%), nondippers (> 0%–10%), reverse dippers (≤ 0%), and extreme dippers (> 20%). A total of 829 CVE (168 fatal) were reported during a median follow-up of 5.7 years. Observations revealed no association of extreme dipping with poorer outcome in people younger than 70 years. In individuals older than 70 years, there was a U-shaped relationship between nocturnal blood pressure dipping and adverse outcome. In the octogenarian extreme dippers, the risk of CVEs was 4× higher relative to the dippers and comparable to that in the reverse dippers.