Why the study?
Patients with a nondipping BP pattern have worse renal and cardiovascular outcomes independent of 24-hour BP levels, but its underlying pathophysiology involves complex mechanisms across multiple pathways.
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Design
Review
Nondipping BP mechanisms remain incompletely defined; leaves open targeted interventions pending prospective validation.
The nondipping blood pressure (BP) pattern corresponds to a disruption in the circadian BP rhythm with an insufficient decrease in BP levels during nighttime sleep as observed using 24-hour ambulatory BP monitoring. Patients with nondipping BP pattern have poorer renal and cardiovascular outcomes, independent of their average 24-hour BP levels. The pathophysiology of nondipping BP is complex and involves numerous mechanisms: perturbations of (1) the circadian rhythm, (2) the autonomic nervous system, and (3) water and sodium regulation. This review provides an outline of the pathways potentially involved in the nondipping BP profile in different conditions. A recent hypothesis is also discussed involving the role of gut microbiota in the dipping/nondipping patterns, via the fecal diet-derived short chain fatty acids.
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Huart et al. (2023) studied this question.
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