title: Non-dipping morning blood pressure and isolated systolic hypertension in elderly.
abstract: OBJECTIVE
  Morning hypertension is currently the blind spot in the clinical practice of hypertension, home 24-hour blood pressure measurement has been recommended in patients with a high clinic blood pressure and patients with target organ damage.
  
  
  OBJECTIVE
  To assess whether an increased early morning blood pressure surge, established via a single 24-hour blood pressure monitoring, in treated elderly hypertensive's is related to more prominent target organ damage.
  
  
  METHODS
  310 treated hypertensive patients randomly attended the out-patient clinic of our hypertension centre. The patients were divided in 2 groups: systolic/diastolic blood pressure hypertension (n = 266) and isolated systolic hypertension (n = 44 76 ± 10 yrs).
  
  
  RESULTS
  Equivalent in both males and females, despite the rise in nondippers with an early morning surge (higher in females). Hyperlipidemia arises equally in dippers and nondippers, 45 % of nondippers had diabetes mellitus; 30 % suffered previous renal insufficiency and about 29 % of patients suffered from an endocrine disorder, mostly thyroid. Metabolic syndrome was only found to be associated with a nondipping pattern (3 %). Left ventricular hypertrophy was present in 100 % of patients, heart failure in 60 % nondippers and 56 % dippers, potential renal insufficiency in 34 % nondippers and 22 % dippers, retinopathy in 31 % non dippers and 11 % dippers, aortic aneurysm was only in nondippers.
  
  
  CONCLUSIONS
  Early morning surge is a predictor of hypertensive target organ damage, being a dipper or nondipper patient with isolated systolic hypertension, might not make a difference depending on one's own degree of target organ damage and diurnal variation (Fig. 2, Ref. 30).
authors: Center for Research, Diagnosis and Treatment of Hypertension, Clinic of Geriatrics and Health Care School of Medical of Medicine, PJ Safarikiensis University, Kosice, Slovakia. mhzain@lf.upjs.sk
authors: M H
authors: MH
authors: Zain-El
authors: M
authors: M
authors: Snincak
authors: K
authors: K
authors: Pahuli
authors: Z
authors: Z
authors: Solarova
authors: P
authors: P
authors: Hrabcakova
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002940:Circadian Rhythm; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D008297:Male; D013599:Systole