title: Causes and consequences of a non-dipping blood pressure profile.
abstract: The development and clinical application of ambulatory blood pressure monitoring (ABP M) has brought several of the main features of the circadian blood pressure (BP) rhythm to light. ABP M has shown to be a very useful method in cardiovascular risk assessment and remains the only method of diagnosing a non-dipping blood pressure profile. A 'non-dipping' BP profile is currently regarded as a risk factor in its own right for cardiovascular (CV) events and target organ damage. Nevertheless, the reliability of ABP M in assessing dipping status is still being questioned. Furthermore, a clear-cut definition of 'non-dipping' has not been established so far. The pathophysiological mechanism(s) of a non-dipping profile might involve abnormalities in extracellular volume and/or vascular resistance regulation. In addition, differences in daytime and nighttime activity, sleep quality and body position during sleep are involved as well. A reduction in cardiovascular risk by a pharmacologically induced switch from a non-dipper to a dipper status might be expected, but remains to be proven.
authors: Department of Internal Medicine, Vascular Pharmacology, Erasmus Medical Centre, 's Gravendijkwal 230, 3015 GD Rotterdam, The Netherlands.
authors: A M
authors: AM
authors: Birkenhäger
authors: A H
authors: AH
authors: van den Meiracker
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D002561:Cerebrovascular Disorders / Q000503:physiopathology*; D002940:Circadian Rhythm / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D011187:Posture / Q000502:physiology; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D012890:Sleep / Q000502:physiology