Nocturnal non-dipping: what does it augur?

TG Pickering, K Kario - Current opinion in nephrology and …, 2001 - journals.lww.com
TG Pickering, K Kario
Current opinion in nephrology and hypertension, 2001journals.lww.com
The non-dipping pattern of blood pressure (defined as a nocturnal fall of less than 10%)
occurs in about 25% of hypertensives, with increased prevalence in certain sub-groups such
as diabetics, African-Americans, and patients with renal disease. It almost certainly has
multiple causes, including factors such as the levels of activity and arousal during both the
day and the night, the depth and quality of sleep, and the activity of the sympathetic nervous
system, among others. In patients with uncomplicated hypertension, the reproducibility is …
Abstract
The non-dipping pattern of blood pressure (defined as a nocturnal fall of less than 10%) occurs in about 25% of hypertensives, with increased prevalence in certain sub-groups such as diabetics, African-Americans, and patients with renal disease. It almost certainly has multiple causes, including factors such as the levels of activity and arousal during both the day and the night, the depth and quality of sleep, and the activity of the sympathetic nervous system, among others. In patients with uncomplicated hypertension, the reproducibility is relatively low. There is evidence suggesting that the non-dipping pattern may have an adverse prognosis: thus, it appears to predict the progression of renal disease, to be associated with increased target-organ damage (in some studies), and also to predict increased cardiovascular morbidity. Antihypertensive drug treatment can normalize the non-dipping pattern, but the therapeutic consequences of this are unknown.
Lippincott Williams & Wilkins