The nocturnal non-dipping pattern of blood pressure occurs in about 25% of hypertensives and appears to predict the progression of renal disease and increased cardiovascular morbidity.
The non-dipping blood pressure pattern is associated with adverse cardiovascular and renal outcomes, though the therapeutic consequences of normalizing it remain unknown.
The non-dipping pattern of blood pressure (defined as a nocturnal fall of less than 10%) occurs in about 25% of hypertensives, with increased prevalence in certain sub-groups such as diabetics, African-Americans, and patients with renal disease. It almost certainly has multiple causes, including factors such as the levels of activity and arousal during both the day and the night, the depth and quality of sleep, and the activity of the sympathetic nervous system, among others. In patients with uncomplicated hypertension, the reproducibility is relatively low. There is evidence suggesting that the non-dipping pattern may have an adverse prognosis: thus, it appears to predict the progression of renal disease, to be associated with increased target-organ damage (in some studies), and also to predict increased cardiovascular morbidity. Antihypertensive drug treatment can normalize the non-dipping pattern, but the therapeutic consequences of this are unknown.
Pickering et al. (Sat,) conducted a review in Hypertension. Nocturnal non-dipping pattern of blood pressure was evaluated. The nocturnal non-dipping pattern of blood pressure occurs in about 25% of hypertensives and appears to predict the progression of renal disease and increased cardiovascular morbidity.