Night-time blood pressure patterns and target organ damage: a review.
BACKGROUND
Individuals who do not have a 10% to 20% reduction in blood pressure (BP) during the night are known as 'nondippers'. The cause of this nondipping phenomenon is not fully understood; however, there is a growing body of evidence linking a nondipping BP pattern with target organ damage.


OBJECTIVE
To review the literature and present an overview of the target organ damage found to be associated with a nondipping BP pattern.


METHODS
PubMed, CINAHL and Medscape searches of all available English language articles from 1986 to 2005 were performed. Search terms included 'BP nondipping', 'BP dipping' and 'target organ damage'.


RESULTS
There is evidence to suggest that individuals with hypertension who exhibit a nondipping BP profile are at higher risk of cardiac and extracardiac morbidity and mortality. In particular, nondippers with essential hypertension have been found to have more advanced left ventricular hypertrophy, left ventricular mass and left ventricular mass index, carotid artery wall thickness, carotid artery atherosclerotic plaques, silent cerebral infarct, stroke, cognitive impairment and microalbuminuria.


CONCLUSIONS
A better understanding of the importance of the circadian variations of BP may help to identify those at higher risk of cardiovascular morbidity and mortality, as well as lay the foundation for interventions to prevent/treat alterations in night-time BP patterns.
Routledge
Faye S
FS
Dalhousie University, School of Nursing, Halifax, Canada. fy688519@dal.ca
McFetridge-Durdle
Judith A
JA
Dean
C R
CR
D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D002940:Circadian Rhythm / Q000502:physiology*; D003072:Cognition Disorders / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D007674:Kidney Diseases / Q000209:etiology* / Q000503:physiopathology