title: Nighttime blood pressure: a target for therapy?
abstract: Ambulatory blood pressure (BP) monitoring is increasingly used in the evaluation of hypertensive patients. The ability to monitor BP throughout the day and night allows the detection of abnormal nocturnal BP patterns, the most common being a "nondipping" pattern, which is associated with increased cardiovascular risk; its correction appears to have a positive impact on cardiovascular outcome. Antihypertensive treatment should be individually adjusted to control BP during both daytime and nighttime. However, drug-induced lowering of nocturnal BP, if excessive, could amplify the morning BP surge in patients with daytime BP elevation, increasing the risk of developing a cardiovascular event. Ambulatory BP monitoring therefore represents a unique tool to establish the most appropriate antihypertensive drug regimen for the individual patient.
authors.affiliation: Division of Clinical Pathophysiology, Centre Hospitalier Universitaire Vaudois, PPA-MP 14/204, CH-1011 Lausanne, Switzerland. Bernard.Waeber@chuv.ch
authors.forename: Bernard
authors.initials: B
authors.lastname: Waeber
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Mourad
authors.forename: Eoin
authors.initials: E
authors.lastname: O'Brien
mesh_terms: D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects*; D018660:Blood Pressure Monitoring, Ambulatory; D019090:Case Management; D055870:Drug Chronotherapy; D019317:Evidence-Based Medicine; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D010507:Periodicity; D012307:Risk Factors; D055502:Secondary Prevention; D020181:Sleep Apnea, Obstructive / Q000150:complications; D012893:Sleep Wake Disorders / Q000150:complications
chemical_list: D000959:Antihypertensive Agents