Key result
Non-dippers, who have a diminished nocturnal fall in blood pressure, show more target organ damage such as left ventricular hypertrophy compared to dippers, likely due to higher average 24-hour BP.
The diurnal pattern of blood pressure, particularly the non-dipping profile, is associated with increased target organ damage such as left ventricular hypertrophy, though its independent prognostic value remains to be definitively proven.
Non-dipping may warrant closer ambulatory monitoring for organ damage risk; leaves open independent prognostic value beyond 24-hour BP averages.
The diurnal rhythm of blood pressure (BP) is influenced by both extrinsic and intrinsic factors, with the former usually being of greater significance. Non-dippers, in whom the normal nocturnal fall of pressure is diminished, have been reported to show more target organ damage (left ventricular hypertrophy (LVH)) than dippers, which may be explained by a higher average 24 h BP. Whether or not the pattern of BP (as opposed to the level) also is prognostically important is probable but unproven, given the known morning surge of the incidence of many acute cardiovascular events. The pathological significance of different diurnal patterns of BP change may depend both on the method of analysis and on the outcome measure used.
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Pickering et al. (1993) conducted a review in Hypertension / Diurnal rhythm of blood pressure. Diurnal rhythm of blood pressure (dipping vs non-dipping) was evaluated. Non-dippers, who have a diminished nocturnal fall in blood pressure, show more target organ damage such as left ventricular hypertrophy compared to dippers, likely due to higher average 24-hour BP.
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