Blunted nocturnal decline in blood pressure.
Blood pressure normally declines 10%-20% from daytime to sleep. Patients with less than a 10% reduction in daytime blood pressure are referred to as nondippers. A blunted nocturnal decline in blood pressure may be due to diminished sodium excretory capacity, alteration in the autonomic nervous system, or other factors. Secondary hypertension should be considered as a possibility. Target organ damage appears to be more common in nondippers, however, poor reproducibility of nondipping status raises the question as to the appropriate duration of monitoring to establish a diagnosis. Nondippers tend to have a greater reduction in nocturnal blood pressure with nonpharmacologic and pharmacologic treatment.
Department of Hypertension and Clinical Pharmacology, Medical College of Georgia, Augusta, GA 30912, USA. mprisant@mail.mcg.edu
L Michael
LM
Prisant
D001794:Blood Pressure; D002940:Circadian Rhythm; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*