Nocturnal Hypertension: The Veiled Dark Side of Hypertension Management in a Real World

Objective: Nocturnal hypertension (NH) is highly prevalent among Chinese and Asian populations, while it is usually undetected and uncontrolled in real world clinical practice. This study is aimed to explore the status of nocturnal blood pressure (BP) control in subjects undergone 24h ambulatory blood pressure monitoring (ABPM) in China. Design and method: A nationwide 24h ABPM database was analyzed. NH was defined as average nighttime BP >=120/70 mmHg according to the recent Chinese and European hypertension guidelines. Results: A total of 210782 Chinese adult subjects undergone 24h ABPM between 2020-2022 with suspected and established hypertension were include in this preliminary analysis. Half of the participants was male, the mean age was 59.5(+/-15.3) years. The average nocturnal BP was 127.8/76.0 (+/- 20.0/ 12.9) mmHg. Overall, nocturnal BP was under controlled (<120/70 mmHg) among 23% of the participants, 20% in male, 26% in female, much less than the 45% of daytime BP control and 35% of 24h average BP control in the total subjects. Nighttime systolic BP <120 mmHg was found in 37% of the participants, while nighttime diastolic BP<70 mmHg was seen in 32% of the participants. Conclusions: NH was uncontrolled in about 3/4 of Chinese adults undergone 24h ABPM, indicating an urgent need for NH detecting and managing in practice.